CardioDx nailed down reimbursement from a major Medicare contractor for its coronary artery disease blood-based test, a significant and potentially lucrative milestone for the California-based, cardiovascular genomic diagnostics company.
The San Francisco Business Times details the coverage decision for the Corus CAD gene expression test. Palmetto GBA, a national Medicare benefits contractor based in Columbia, SC, made the decision retroactive to Jan. 1, 2012, a move benefiting as many as 40 million Medicare patients. The Corus CAD has been available in the U.S. since mid 2009. Contained in a shoebox-sized kit, it measures RNA levels of 23 genes to help determine if a patient has obstructive coronary artery disease.
Diagnostics and device companies generally start to breathe easier after Medicare contractors agree to cover a test, implant or other device. That's because private insurers often agree to follow Medicare's lead, as the story notes. Until now, CardioDx negotiated coverage with those companies on a case-by case basis, the article explains.
CardioDx, which launched in 2004, has been preparing for this moment for some time. The Palo Alto company made waves in 2011 after bringing in $60 million in new venture funding, designed in part to help propel expanded reimbursement coverage for Corus CAD. The funding, from a number of venture firms, including JPMorgan partners, Pappas Ventures and Kleiner Perkins Caufield & Byers, became one of the top ten medical device venture capital deals in the first half of 2011.
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