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Myriad's Prolaris Test Gets Final LCD From Medicare Contractor Noridian

NEW YORK (GenomeWeb) – Medicare contractor Noridian has issued a final local coverage decision (LCD) for Myriad Genetics' Prolaris, a test for gauging prostate cancer aggressiveness.

In January this year, another Medicare contractor, Palmetto GBA, issued a final LCD on the same test when used for low- and very low-risk prostate cancer patients. Similarly, the final LCD from Noridian, which goes into effect on October 15, will cover testing for prostate cancer patients defined as low and very low risk by the National Comprehensive Cancer Network. 

During an earnings call this week, Myriad executives said they were awaiting word from Noridian, and that the final LCD would bolster adoption for the test. "The [Noridian] decision is an important step in providing Medicare reimbursement for this life-saving test and will significantly increase patient access to Prolaris testing in the United States," Myriad CEO Mark Capone said in a statement today.

Myriad estimated that the Medicare coverage decision provides test reimbursement for around 60,000 patients diagnosed annually in the US with localized prostate cancer, and who meet the criteria in terms of Gleason score and serum prostate specific antigen levels. The company has presented data showing that 48 percent of doctors changed their treatment strategy based on Prolaris scores, and the majority of these decisions were to take a less aggressive approach.

Myriad believes that Prolaris can save the healthcare system $6 billion over ten years.