THU Health Care Report: Exact Sciences touting new Medicare coverage pathway for cancer blood test

From WisPolitics.com/WisBusiness.com …

— Newly passed federal legislation is giving Exact Sciences greater certainty about investing in its early cancer detection program. 

That’s according to Dr. Tom Beer, chief medical officer of multi-cancer early detection at the Madison-based diagnostics business. 

In an interview today, he noted the recent federal funding package included legislation creating a new benefit category under Medicare for tests like the company’s Cancerguard blood test. It can check for more than 50 different cancers and subtypes and is meant to complement more specific standard cancer screening. 

“Our long-term goals couldn’t be achieved without something like this,” Beer said. “Our flagship screening test, Cologuard, is available universally with 96% of Americans being able to access it without a copay. So that’s what we want to achieve with Cancerguard to really have an impact on human health.” 

That target can’t be met without making the test available to Medicare beneficiaries, according to Beer. 

“It’s absolutely critical to the long-term vision to have our test available for Americans over the age of 65, and this is the pathway to do that,” he said. 

Exact Sciences launched the test before this version of the bill came about, but Beer said the legislative effort had been going on for years. The legislation was based on the Nancy Gardner Sewell Medicare Multi-Cancer Early Detection Screening Coverage Act, according to a release from the company. 

While the legislation doesn’t guarantee Exact Sciences’ Cancerguard test will be covered by Medicare, it establishes a pathway for that to occur. It specifies that the FDA needs to approve tests that the Centers for Medicare and Medicaid Services will cover, Beer explained, adding the company plans to seek FDA approval for its cancer blood test. 

After that point, CMS will evaluate whether the Cancerguard test is worthwhile for Medicare beneficiaries. Beer said the company is “very optimistic” about getting that approval. 

“We think this is going to have a really big public health impact,” he said. 

See the release below. 

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