The final decision includes some changes, most notably removing requirements for guideline inclusion, but retains its technical performance benchmarks.
The agency issued a new draft decision memo, outlining various criteria it intends to apply when determining coverage for current and future blood-based CRC screening tests.
Myriad Genetics' EndoPredict, Agendia's MammaPrint (distributed in Germany by PathoNext), and Veracyte's Prosigna will now be covered by public insurance.
Researchers concluded that there has been significant expansion of coverage for ctDNA assays over the past four years, but policies remain very heterogeneous and often limited.
In response to CMS reopening its national coverage determination to address its germline testing policy, stakeholders point out areas of concern and confusion.
The institute has recommended the drug as a cost-effective use of NHS resources following submission of new evidence and reflecting a confidential price discount arrangement.
As of July 1, the Guardant360 test will be considered medically necessary for aiding therapy selection in advanced lung cancer for health plan members of EviCore.
City of Hope and Texas Oncology are the first customers for Trapelo, a decision support platform from Innovation Insights that involves labs and payors.
Although a draft guidance last month recommended against use of molecular tests to guide chemotherapy, the group's finalized decision is subject to price negotiation and other adjustments.
Winship's director of the cancer tissue and pathology shared resource said that some labs aren't leveraging molecular technologies due to reimbursement issues.
