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National Coverage Analysis (NCA) Tracking Sheet for Aprepitant for Chemotherapy-Induced Emesis (CAG-00248R)

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Aprepitant (Emend®) is an orally administered neurokinin-1 antagonist that is proposed to function in combination with other oral anti-emetics specifically for patients receiving highly or moderately emetogenic chemotherapy.

In April 2005, the Centers for Medicare and Medicaid Services (CMS) published a National Coverage Decision (NCD) for Aprepitant for Chemotherapy-Induced Emesis (110.18). At that time, CMS determined that the evidence was adequate to conclude that the oral anti-emetic three drug combination of aprepitant (Emend®), a 5-HT3 antagonist, and dexamethasone is reasonable and necessary for patients who are receiving one or more of the following highly emetogenic anti-cancer chemotherapeutic agents:

- Carmustine, - Cisplatin, - Cyclophosphamide,
- Dacarbazine, - Mechlorethamine, - Streptozocin,
- Doxorubicin, - Epirubicin, - Lomustine

CMS is reconsidering NCD 110.18 to review the evidence on the use of oral aprepitant (Emend®) in combination with dexamethasone and a 5-HT3 antagonist in patients receiving moderately emetogenic anti-cancer chemotherapeutic agents

Oral Antiemetic Drugs
Requestor Name(s):  Patricia J. Goldsmith, Executive Vice President & Chief Operating Officer, National Comprehensive Cancer Network
Requestor Letter(s):  View Letter
Formal Request Accepted and Review Initiated:  10/01/2012
Expected NCA Completion Date:  06/18/2013
Public Comment Period:  10/01/2012 - 10/31/2012
Proposed Decision Memo Released:  03/20/2013
Proposed Decision Memo Public Comment Period: 03/20/2013 - 04/19/2013 
The comment period end date remains 4/19/2013. The date in the end date field has been changed to prevent an error message when submitting a comment on 4/19/2013. Thank you.
Comments for this NCA::  View Public Comments
Lead Analyst(s): 
October 1, 2012

CMS opens this reconsideration of the NCD for Aprepitant for Chemotherapy-Induced Emesis (110.18), in order to reevaluate the use of the use of oral aprepitant (Emend®) in combination with dexamethasone and a 5-HT3 antagonist in patients receiving moderately emetogenic anti-cancer chemotherapeutic agents. The initial 30-day public comment period begins with this posting date, and ends after 30 calendar days. CMS considers all public comments.

Instructions on submitting comments can be found at http://www.cms.hhs.gov/InfoExchange/02_publiccomments.asp#TopOfPage

You can also submit a public comment by clicking on the highlighted word COMMENT in the title bar at the top of this page. We strongly urge that all public comments be submitted through this website. Please do not submit personal health information in public comments. Comments with personal health information may not be posted to the website.
March 20, 2013 Posted proposed decision memo
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