Telix Pharmaceuticals (ASX:TLX) has welcomed proposed changes announced by the US Centers for Medicare and Medicaid Services (CMS).
The changes will apply to the Hospital Outpatient Prospective Payment System (OPPS) rule and improve payments for diagnostic radiopharmaceuticals for Medicare patients. They will facilitate continued patient access after transitional pass-through payment status expires.
Under the proposed changes, diagnostic radiopharmaceuticals, including Illuccix, will continue to be paid separately by CMS for traditional Medicare Fee for Service patients in the hospital outpatient setting following the expiry of transitional pass-through payment status.
This change would also apply to new diagnostic products being developed by Telix, if approved.
Currently, in the US, the costs associated with diagnostic radiopharmaceuticals are packaged into the payment for the nuclear medicine tests.
The CMS is proposing refinements to this policy to improve the accuracy of overall payment amounts by paying separately for any diagnostic radiopharmaceutical with a per day cost greater than US$630.
Kevin Richardson, CEO of Telix Americas, said, “Telix welcomes the proposed rule, which will facilitate more equitable and reliable access to advanced imaging for all patients and support physicians to prescribe the most clinically appropriate solution. We commend the vision of CMS and the coalition, along with patient groups, for raising awareness about the necessity to reform the payment system to enhance patient outcomes and access. Telix is committed to continued innovation in the field of radiopharmaceutical diagnostics to provide new solutions to further patient access, especially for underserved patient populations and in areas of high unmet clinical need.”