OSLO, Norway, Nov. 5, 2019 /PRNewswire/ -- Photocure ASA.,
(OSE: PHO), The United States Centers for Medicare and Medicaid
Services (CMS) has released its Final Rule maintaining the
reimbursement code (A Code) for Cysview when used in hospital
outpatient and other sites of care and improved the complexity
adjustment codes. This will result in additional
reimbursement of $92 for certain Blue
Light Cystoscopy (BLC™) procedures when used in hospital outpatient
departments effective January 1st,
2020.
Link for access to the Rule:
https://s3.amazonaws.com/public-inspection.federalregister.gov/2019-24138.pdf
In addition, CMS confirmed that the complexity adjustment will
be available for procedures billed under 52204, 52214, and 52224
(52214 being new for 2020), if also billed with the A9589 code for
the drug and the C9738 code for the complexity adjustment.
The increased reimbursement due to the complexity adjustment will
be $1,247 ($1,187 in 2019). This will result in an
increase in reimbursement of payment for Blue Light Cystoscopy
procedures when used in hospital outpatient department under the
complexity adjustment conditions applicable to the three procedures
in 2020 from standard white light at $1,771 (for APC 5373) to $3,018 with Cysview (for APC 5374).
"The effectiveness and benefits of using Blue Light
Cystoscopy (BLC™) with Cysview for improved detection and
management of bladder cancer are widely recognized. We are pleased
that CMS has implemented an additional complexity adjustment code
for Cysview and improved reimbursement compared to 2019. We,
along with many stakeholders in the Bladder Cancer Community,
(including the Large Urology Group Practice Association (LUGPA),
American Urological Association (AUA), the patient advocacy group
Bladder Cancer Advocacy Network (BCAN), and individual Urologists
and Patients), will continue to work to further increase access for
all patients regardless of the site of care to this leading-edge
technology for the management of bladder cancer," commented
Dan Schneider, President and Chief
Executive Officer of Photocure ASA.
About Bladder Cancer
Bladder cancer ranks as the ninth most common cancer worldwide
with 430 000 new cases and more than 165 000 deaths annually.
Approx. 75% of all bladder cancer cases occur in men1.
It has a high recurrence rate with an average of 61% in year one
and 78% over five years2. Bladder cancer has the highest
lifetime treatment costs per patient of all
cancers3.
Bladder cancer is a costly, potentially progressive disease for
which patients have to undergo multiple cystoscopies due to the
high risk of recurrence. There is an urgent need to improve both
the diagnosis and the management of bladder cancer for the benefit
of patients and healthcare systems alike.
Bladder cancer is classified into two types, non-muscle invasive
bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC),
depending on the depth of invasion in the bladder wall. NMIBC
remains in the inner layer of cells lining the bladder. These
cancers are the most common (75%) of all BC cases and include the
subtypes Ta, carcinoma in situ (CIS) and T1 lesions. MIBC is when
the cancer has grown into deeper layers of the bladder wall. These
cancers, including subtypes T2, T3 and T4, are more likely to
spread and are harder to treat4.
About
Hexvix®/Cysview® (hexaminolevulinate
HCl)
Hexvix®/Cysview® is a drug that is
selectively taken up by tumor cells in the bladder making them glow
bright pink during Blue Light Cystoscopy (BLCTM). BLC™
with Hexvix® /Cysview® improves the detection
of tumors and leads to more complete resection, fewer residual
tumors and better management decisions.
Cysview® is the tradename in the US and Canada, Hexvix® is the tradename in
all other markets. Photocure is commercializing Cysview®
/ Hexvix® directly in the US and the Nordic region and
has strategic partnerships for the commercialization of
Hexvix® / Cysview® in Europe, Canada, Australia and New
Zealand. Please refer to https://bit.ly/2wzqSQQ for further
information on our commercial partners.
All trademarks mentioned in this release are protected by law
and are registered trademarks of Photocure ASA
This press release may contain product details and information
which are not valid, or a product is not accessible, in your
country. Please be aware that Photocure does not take any
responsibility for accessing such information which may not comply
with any legal process, regulation, registration or usage in the
country of your origin.
References
1. Globocan. Incidence/mortality by population. Available
at: http://globocan.iarc.fr/Default.aspx
2. Babjuk M, Burger M, Zigeuner R, Shariat SF, van Rhijn BW,
Compérat E, et al. EAU Guidelines on non-muscle-invasive bladder
cancer (Ta, T1 and CIS). Eur Urol. 2016 Guidelines
Edition:1-40.
3. Sievert KD et al. World J Urol 2009;27:295-300
4. Bladder Cancer. American Cancer Society.
https://www.cancer.org/cancer/bladder-cancer.html
CONTACT:
For more information, please contact:
Dan Schneider
President and CEO
Photocure ASA
Tel: + 1-609-759-6515
Email: ds@photocure.com
Erik Dahl
CFO
Photocure ASA
Tel: +47-450-55-000
Email: ed@photocure.com
This information was brought to you by Cision
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SOURCE Photocure