Bill Boosts Treatments for Smokers

[RandyW]

The health-care overhaul that passed the Senate Finance Committee this week doesn't just include sweeping changes in taxes and insurance coverage. It also contains smaller items sought by various groups, and jockeying over them is likely to intensify as the bill moves toward final debate.

One such item could mean good news for Pfizer Inc. and GlaxoSmithKline PLC. The legislation provides more Medicaid coverage for smoking-cessation medicines such as Chantix, made by Pfizer, and Zyban, made by Glaxo. Currently the drugs are on an "excludable" list, meaning it is up to states whether to cover them in Medicaid, the federal-state health program for the poor. The bill would take the drugs off the list effective January 2014.

More than three-fourths of the states provide some coverage of antismoking therapies, but policies vary. The therapies include medications, nicotine-replacement products and counseling. In some states, coverage is limited to a short duration, such as 90 days.

Cancer-patient advocacy groups and antismoking groups helped make the case for better Medicaid coverage of such medicines, Senate staffers said. These groups are also pushing for a bill sponsored by Sen. Richard Durbin (D., Ill.) that would extend Medicare and Medicaid coverage for smoking-cessation drugs and counseling programs. That bill is separate from the health plan.

This week, the American Cancer Society said it would closely track the language as the Finance Committee health-overhaul bill wends its way through Congress. "Ideally, we'd like to see mandated coverage in all instances [Medicare, Medicaid, private insurance] for prescription drugs and therapies needed to prevent or treat cancer," said spokesman Steve Weiss.

Pfizer spokeswoman Sally Beatty said it supports measures in the health bill to prevent disease, and that more than 440,000 people in the U.S. die yearly from smoking-related illnesses.

Chantix's label warns that serious events including suicide have been reported in patients taking the drug, but studies have shown it to be effective in helping people quit smoking. The drug recorded $228 million in U.S. sales in the first half of 2009.

Glaxo said the Senate Finance provision, if it becomes law, would be good news for patients. A congressional aide involved in the health bill said the costs of treating lung cancer were higher than the costs of drugs that might help a smoker quit.

Other relatively small provisions in the bill have also drawn controversy. Senate Majority Leader Harry Reid successfully pushed to ensure the federal government would pay the full cost of expanding Medicaid in his home state, Nevada, and three other states. Mr. Reid said he would make no apologies for helping his state, which has suffered from the housing downturn.

Write to Alicia Mundy at alicia.mundy@wsj.com

Printed in The Wall Street Journal, page A5