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Narcotic analgesics

Administration of morphine when used in the treatment of intractable pain caused by cancer is covered in the home.

Administration of narcotic analgesics (except meperidine) in place of morphine to a patient with intractable pain caused by cancer who has not responded to an adequate oral/transdermal therapeutic regimen and/or cannot tolerate oral/transdermal narcotic analgesics is covered if either of the following sets of criteria are met:

Criteria set 1
1. Parenteral infusion in the home is reasonable and necessary.
2. An infusion pump is necessary to safely administer the drug.
3. The drug is administered by a prolonged infusion of at least 8 hours because of proven improved clinical efficacy.
4. The therapeutic regimen is proven or generally accepted to have significant advantages over intermittent bolus administration regimes or infusions lasting less than 8 hours.

Criteria set 2
1. Parenteral administration of the drug in the home is reasonable and necessary.
2. An infusion pump is necessary to safely administer the drug.
3. The drug is administered by intermittent infusion (each episode of infusion lasting less than 8 hours) which does not require the patient to return to the physician's office prior to the beginning of each infusion.
4. Systemic toxicity or adverse effects of the drug is unavoidable without infusing it at a strictly controlled rate as indicated in the Physicians Desk Reference, American Medical Associations drug Evaluations, or the U.S. Pharmacopeia Drug Information.

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