Yes, the article goes into detail on how all this off-label cancer use is being covered.
Quote:The NCCN is a prominent set of cancer specific guidelines used in clinical practice and now serves as one of five compendiums for private insurer and the Centers for Medicare and Medicaid Services (CMS) coverage. The process by which the NCCN issues its guidelines involves 54 individual panels comprising more than 1275 clinicians and oncology researchers from 27 member institutions. Per the NCCN website “The development of the NCCN Guidelines is an ongoing and iterative process, which is based on a critical review of the best available evidence and derivation of recommendations by a multidisciplinary panel of experts in the field of cancer.” The guidelines developed by these disease specific panel members result in algorithmic pathways delineating the process from staging through treatment and surveillance.3 The guidelines are updated at a minimum annually but often more frequently. For transparency, the NCCN posts short summaries of the meetings and panel discussions as well as disclosures of conflicts of interest. There is no mention of how the evidence is gathered or reviewed for recommendations.
In 1993, as part of the Omnibus Budget Reconciliation act, Congress mandated that CMS use three expert compendiums to determine coverage decisions for off-label drugs used in cancer care.4 In other words, CMS would reimburse for off-label use if the compendiums sanctioned that use. Over time, the number of compendiums has grown. As of 2016, there are now five: Wolters Kluwer Clinical Drug Information Lexi-Drugs, the American Hospital Formulary Service, Clinical Pharmacology, Micromedex DrugDex, and the National Comprehensive Cancer Network Drugs and Biologics accepted by the CMS.5 These compendiums are often used by commercial insurance providers for coverage decisions.6
