Analysts see a new proposed local coverage determination (LCD) from CMS as a potential boost for Dexcom (Nasdaq:DXCM) and Abbott (NYSE:ABT). The Centers for Medicare and Medicaid Services (CMS) yesterday published the LCD modifying coverage criteria for continuous glucose monitors (CGMs). The modification includes people with diabetes who receive insulin treatment or have a history […]
Centers for Medicare and Medicaid Services (CMS)
Analysts say high payor coverage, increased CGM adoption bodes well for Abbott, Dexcom
Analysts have suggested that companies like Abbott (NYSE:ABT) and Dexcom (Nasdaq:DXCM) may benefit from expected reimbursement progress. BTIG hosted a conference call with North Shore Medical Center (Salem, Massachusetts) Medical Director Dr. Gary Cohen and Healthcare Analytics, LLC analyst and consultant Dr. Joshua Cohen. The two experts offered insights into prescriber and patient interest in […]
Medtronic announces recent reimbursement wins for CGMs in a number of geographies
Medtronic (NYSE:MDT) announced today that reimbursement for its CGMs has been expanded or initiated across a number of countries. Earlier this month, the Ontario, Canada provincial government announced a comprehensive reimbursement program for continuous glucose monitoring (CGM) for eligible residents who have type 1 diabetes, adding to a similar program for those with type 1 […]
CMS expands Medicare coverage to CGMs that integrate with Medtronic insulin pumps
Medtronic (NYSE:MDT) announced today that the U.S. Centers for Medicare & Medicaid Services (CMS) will expand coverage for CGMs. CMS’ expanded coverage covers all types of CGMs (continuous glucose monitors), including adjunctive and non-adjunctive CGMs, and it notably covers CGMs that integrate with Medtronic insulin pumps. According to a news release, the proposed rule was […]
Massachusetts offers Medicaid coverage for Pear Therapeutics’ digital therapeutics
Pear Therapeutics announced today that MassHealth intends to cover the company’s prescription digital therapeutics (PDTs). MassHealth, Massachusetts’ Medicaid program, notified Pear of its plans to cover the FDA-authorized reSET and reSET-O PDTs for treating substance use disorder and opioid use disorder, respectively. The decision remains subject to certain customary conditions, including federal and state approvals as […]
Xeris reaches payor coverage milestone for glucagon injection
Xeris Pharmaceuticals (NSDQ:XERS) announced today that it achieved a milestone for the payor coverage of its Gvoke glucagon injection. Approximately 91% of Medicare patients, 88% of commercially insured patients and a growing number of Medicaid lives have unrestricted access to Gvoke, Xeris said in a news release. Chicago-based Xeris’ Gvoke, a ready-to-use pre-mixed, pre-measured glucagon […]
CMS consolidates coverage for Intersect ENT’s corticosteroid-eluting implant
Intersect ENT (NSDQ:XENT) announced today that it received consolidated Medicare coverage for its Sinuva sinus implant. Menlo Park, Calif.-based Intersect ENT said in a news release that CMS published an average selling price (ASP) for the Sinuva implant, providing predictability, transparency and confidence of reimbursement for providers and payers in the future. Sinuva is a […]
Abbott wins Medicare reimbursement for FreeStyle Libre 2
Abbott (NYSE:ABT) announced today that its next-generation FreeStyle Libre 2 iCGM is now available to Medicare patients. The integrated continuous glucose monitoring (iCGM) system met the codes for therapeutic CGM systems used for coverage by the U.S. Centers for Medicare & Medicaid Services (CMS), making it accessible to all Medicare patients with diabetes who meet the […]
Abbott, Medtronic go head-to-head at ADA conference
Major medtech companies vied for the biggest news splash at this year’s annual meeting of the American Diabetes Association, announcing promising results from studies of patients who used their latest diabetes technology. The virtual 80th Annual American Diabetes Association Virtual Scientific Sessions, which runs through Tuesday, so far has featured news out of Abbott (NYSE:ABT) and Medtronic (NYSE:MDT) and several smaller […]
Mylan agrees to settle SEC EpiPen probe for $30 million
Mylan (NSDQ:MYL) is nearing a $30 million settlement with the Securities and Exchange Commission (SEC) over an investigation involving the company’s EpiPen auto-injector and the Medicaid drug rebate program. The SEC probe was announced in 2016, shortly after Mylan agreed to pay $465 million to the U.S. Department of Justice to settle claims that it […]
