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Ishmael frequently adjusted a patient's chemotherapy treatment in
accordance with the patient's response to the treatment.
The Chemotherapy Drugs and Ancillary Medications Used in
Treatments
After a chemotherapy drug has been tested and scientifically
proven effective to treat a particular condition, it is approved
for use by the Food and Drug Administration. Once a drug is
approved, it can be used to treat conditions other than those for
which it is approved because chemotherapy drugs may be effective
against multiple forms of cancer. For example, a drug approved
for use against ovarian cancer might be used to treat lung
cancer, even though its use to treat lung cancer is not an
approved use. Petitioners were not reimbursed by Medicare for
their use of approved drugs if the condition for which the drug
was administered was not an approved use, on the grounds that
such treatments were experimental.
Dr. Ishmael treated some of his patients with drugs that
were not approved for a particular condition when he believed the
drug would help those patients, even though he knew that Medicare
or nongovernmental health insurance carriers (private insurers)
would not pay for costs associated with experimental treatments.
Although petitioners bore the cost of these treatments, Dr.
Ishmael authorized the treatments when he felt that they were
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Last modified: May 25, 2011