(Xconomy Boston) Mar 19, 2018 - The Centers for Medicare & Medicaid Services, which administers the federal Medicare insurance program, will begin covering FDA-approved diagnostic tests that scan tumors for a range of genetic mutations.
Winston Wong, PharmD (Posted: April 05, 2018)
From a payer perspective, the CMS approval for coverage means that reimbursement for medicare and medicaid plans are mandated. This does not mean that coverage for the commercial population is mandated. Coverage for commercial members will be based upon the clinical utility study results. If the tests are specific to a drug, and will predict if a drug will be effective or not, then commercial business will follow suit. This is because the clinical utility of the test is sound. Anything beyond this will be suspect, and will undergo much scrutiny. There still need to be clinical justification for coverage. As I have noted in the past, FDA approved indication based upon genomic profiling results will prove to be a challenge for payers, and so far, that has held true.
(MarketWatch) Mar 18, 2018 - Foundation Medicine, Inc. today announced that the Centers for Medicare & Medicaid Services (CMS) issued a final National Coverage Determination (NCD) for patients who receive next generation sequencing (NGS) testing with an assay that meets the coverage criteria.
Thomas Marsland, MD (Posted: March 27, 2018)
Who says you can't teach an old dog new tricks..... I am delighted to see this NCD. In my practice I have been using more and more NGS. These technologies have allowed me to use a much more personalized approach to many patients with difficult to treat tumors. New cancer with an aggressive clinical presentation now have the option of more targeted treatments. Also patients who have been on treatments for a time have additional choices to help control their cancers. This move keeps in step with the evolving trend of thinking of cancers biologically as opposed to anatomically. It is very encouraging to see the payer community more and more accepting of target therapies across tumor types. The wider usage of Foundation One testing will allow wider access to more effective treatments SO Woof, Woof from an old dog.....
(Merck) Mar 14, 2018 - Late-breaker presentation of overall survival and progression-free survival results from pivotal phase 3 KEYNOTE-189 trial with KEYTRUDA ® (pembrolizumab) plus pemetrexed and platinum chemotherapy in first-line treatment of advanced nonsquamous non-small cell lung cancer; first-time KEYTRUDA data including recurrence-free survival from phase 3 KEYNOTE-054 Study, in collaboration with EORTC, in patients with stage III surgically resected high-risk melanoma.
H. Jack West, MD (Posted: March 15, 2018)
This presentation of data from KEYNOTE-189, CheckMate-227, IMpower150, and some other trials of immunotherapy combinations in first line advanced NSCLC will be in the same blockbuster session on late Monday morning at AACR. This two hour period will likely have a significant impact on lung cancer practice this year. All eyes interested in the field should be watching around that time.
Professor of Medicine, Division of Hematology/Medical O...
Professor and Director, Division of Hematology Oncology...
