Insurers expand coverage of prostate cancer tests

February 25, 2014

The makers of the Decipher and ConfirmMDx prostate cancer tests have announced separate agreements that will expand insurance coverage for the two tests.

The makers of the Decipher and ConfirmMDx prostate cancer tests have announced separate agreements that will expand insurance coverage for the two tests.

GenomeDx Biosciences said it has entered into a contractual agreement to provide the Decipher test to FEDMED payers. FEDMED is a national provider network that covers over 40 million lives.

The Decipher prostate cancer classifier directly measures a patient’s biological risk of developing metastatic prostate cancer. GenomeDx, which discovered and developed the test, will provide laboratory services to the FEDMED network. FEDMED payers will provide insurance coverage for physicians who order the Decipher test for their patients.

The agreement brings the number of covered lives with access to Decipher to over 100 million, GenomeDx said.

Separately, MDxHealth SA has signed an agreement with Prime Health Services, Inc. a preferred provider organization network.  The agreement covers all 50 states, offering patients greater access to MDxHealth’s ConfirmMDx for Prostate Cancer test. This agreement extends the use of the test to approximately 144 million covered lives throughout the United States, the company said.

ConfirmMDx addresses the unmet need associated with the high rate of repeat prostate biopsies. As the company captures more contracts, MDxHealth said it expects to shorten the reimbursement cycle as it transitions more payers to an accrual basis and increase revenue recognition in 2014.

 

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