Medicare Issues Proposed Local Coverage Determination that Provides Coverage of Optune® for Newly Diagnosed Glioblastoma
ST. HELIER, Jersey–(BUSINESS WIRE)– Novocure (NASDAQ: NVCR) today announced the Medicare durable medical equipment (DME) Medicare Administrative Contractors (MACs) have issued a proposed local coverage determination (LCD) that provides coverage of Tumor Treating Fields, or Optune, for newly diagnosed glioblastoma (GBM). Proposed LCDs are subject to a 45-day public comment period during which the DME MACs will consider feedback from patients, advocacy groups, prescribers and the general public prior to finalizing the LCD.
The coverage policy criteria proposed by the DME MACs is generally similar to Optune’s commercial coverage criteria for newly diagnosed glioblastoma (GBM) with the exception of a proposed restriction on beneficiary site of care.
The proposed coverage policy is now subject to public comment through June 24, 2019. An open meeting will be held at the Westin Baltimore Washington International Airport on June 20, 2019 to discuss the proposed policy. Following the public comment period, a final LCD will be published that includes a response to public comments received.
“We view the proposed LCD as a positive step forward in a multi-step process,” said Bill Doyle, Novocure’s Executive Chairman. “We are committed to ensuring patients have equitable access to Optune and now will work with our patients and prescribers to help their voices be heard during the public comment period.”
“On behalf of the Musella Foundation For Brain Tumor Research & Information, Inc., we applaud the DME MACs for issuing a draft LCD allowing coverage of Optune for newly diagnosed GBM patients,” noted Al Musella, DPM, President of the Musella Foundation. “This is a positive first step towards ensuring equitable access to care for Medicare beneficiaries. We have concerns, which we will share directly with the DME MACs, with the proposed limitations on where patients can access Optune. We believe strongly that all Medicare beneficiaries should have access to the therapy deemed appropriate by their healthcare providers.”
Optune is intended as a treatment for adult patients (22 years of age or older) with histologically-confirmed glioblastoma multiforme (GBM).
Optune with temozolomide is indicated for the treatment of adult patients with newly diagnosed, supratentorial glioblastoma following maximal debulking surgery and completion of radiation therapy together with concomitant standard of care chemotherapy.
For the treatment of recurrent GBM, Optune is indicated following histologically-or radiologically-confirmed recurrence in the supratentorial region of the brain after receiving chemotherapy. The device is intended to be used as a monotherapy, and is intended as an alternative to standard medical therapy for GBM after surgical and radiation options have been exhausted.
Patients should only use Optune under the supervision of a physician properly trained in use of the device. Full prescribing information is available at www.optune.com/safety or by calling toll free 1-855-281-9301.
Important Safety Information
Contraindications: Do not use Optune if you have an active implanted medical device, a skull defect (such as, missing bone with no replacement), or bullet fragments. Use of Optune together with implanted electronic devices has not been tested and may theoretically lead to malfunctioning of the implanted device. Use of Optune together with skull defects or bullet fragments has not been tested and may possibly lead to tissue damage or render Optune ineffective.
Do not use Optune if you are known to be sensitive to conductive hydrogels. In this case, skin contact with the gel used with Optune may commonly cause increased redness and itching, and rarely may even lead to severe allergic reactions such as shock and respiratory failure.
Warnings and Precautions: Use Optune only after receiving training from qualified personnel, such as your doctor, a nurse, or other medical personnel who have completed a training course given by Novocure (the device manufacturer).
Do not use Optune if you are pregnant, you think you might be pregnant or are trying to get pregnant. It is not known if Optune is safe or effective in these populations.
The most common (≥10%) adverse events involving Optune in combination with temozolomide were low blood platelet count, nausea, constipation, vomiting, fatigue, scalp irritation from device use, headache, convulsions, and depression.
The most common (≥10%) adverse events seen when using Optune alone were scalp irritation from device use and headache.
The following adverse reactions were considered related to Optune when using the device alone: scalp irritation from device use, headache, malaise, muscle twitching, fall and skin ulcer.
All servicing procedures must be performed by qualified and trained personnel.
Do not use any parts that do not come with the Optune Treatment Kit, or that were not sent to you by the device manufacturer or given to you by your doctor.
Do not wet the device or transducer arrays.
If you have an underlying serious skin condition on the scalp, discuss with your doctor whether this may prevent or temporarily interfere with Optune treatment.
Please see http://www.optune.com/safety to see the Optune Instructions For Use (IFU) for complete information regarding the device’s indications, contraindications, warnings, and precautions.
Patients should only use Optune under the supervision of a physician properly trained in use of the device.
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