CMS Grants Progenics New Technology Add-On Payment for Inpatient Use of AZEDRA

Progenics Pharmaceuticals (NASDAQ:PGNX) has announced that the Centers for Medicare & Medicaid Services (CMS) approved a new technology add-on payment (NTAP) for AZERDA.

As quoted in the press release:

The NTAP program will provide qualifying Medicare hospital inpatient cases with a payment, in addition to the standard-of-care Diagnostic Related Group (DRG) reimbursement, of up to 65% of the cost of AZEDRA for a period of two to three years, effective October 1, 2019.  CMS has assigned a maximum payment of $98,150 for a patient treated with a dose of AZEDRA.

In the final rule concerning Hospital Inpatient Prospective Payment Systems and Fiscal Year 2020 Rates, CMS stated about AZEDRA “…use of the technology suggested a durable response in the reduction of hypertension as measured by the primary endpoint plus the confirmed overall tumor response measures of direct clinical benefit in this population of patients with serious, life threatening and rare disease” and that “AZEDRA^® meets all of the criteria for approval of new technology add-on payments, and we are approving new technology add-on payments.”

“Receiving NTAP designation is an important step for physician and patient access to AZEDRA and underscores the importance of AZEDRA as a treatment option with substantial clinical benefit in the view of CMS,” said Bryce Tenbarge, Senior Vice President, Commercial at Progenics.  “The NTAP program plays a vital role in providing supplemental reimbursement for the inpatient administration of AZEDRA.  Fewer than 30%¹ of the products that have ever been proposed were granted this special add-on payment for the inpatient hospital setting. Not only does this mean that there will be an increased payment amount to hospitals for AZEDRA when administered in the inpatient hospital setting, it most importantly means that access has been greatly improved for the Medicare patients we serve.”

Click here to read the full press release.