Adaptive Biotechnologies Corporation (Nasdaq: ADPT), a commercial
stage biotechnology company that aims to translate the genetics of
the adaptive immune system into clinical products to diagnose and
treat disease, announced today that the new Medicare Clinical
Laboratory Fee Schedule (CLFS) rate for its next-generation
sequencing (NGS)-based clonoSEQ® test for minimal – or measurable –
residual disease (MRD) assessment is now in effect as of January 1,
2025. The CLFS rate for clonoSEQ (PLA 0364U) was set at $2,007,
consistent with the final gapfill rate recommendation for the test.
The CLFS, managed by the Centers for Medicare & Medicaid
Services (CMS), establishes payment rates for lab tests covered by
Medicare. Novel diagnostic laboratory tests like clonoSEQ, for
which there is no existing comparable test, undergo a special
pricing process known as gapfill determination. In this process,
Medicare assesses the test’s value by considering factors such as
the resources required to perform the test, rates paid for the test
by other payers, rates paid for tests leveraging similar
technologies, and additional unique attributes of the test. After a
year of evaluation, CMS finalizes a national rate to ensure that
essential tests like clonoSEQ are fairly priced and accessible to
patients who need them. Many other payers in the US look to the
Medicare CLFS in establishing their rate schedules for diagnostic
tests that they cover.
As previously announced, MolDX has also updated clonoSEQ episode
pricing to $8,029, in line with this new CLFS rate across all
covered indications, including multiple myeloma, chronic
lymphocytic leukemia, B-cell acute lymphoblastic leukemia,
circulating tumor DNA-based MRD testing in diffuse large B-cell
lymphoma and mantle cell lymphoma.
“Finalizing the Medicare reimbursement rate for clonoSEQ through
the gapfill process represents another key milestone and highlights
the value of the test in patient care,” said Ben Eckert, senior
vice president, Market Access, Adaptive Biotechnologies. “MRD
testing provides clinicians with essential insights into a
patient’s disease status and response to therapy. With the newly
defined rate, we look forward to driving broader adoption by
healthcare providers and private insurers, expanding accessibility
for patients living with blood cancers."
The clonoSEQ test provides accurate and sensitive measurement of
MRD in lymphoid malignancies and is widely covered by both Medicare
and commercial payers for patients with lymphoid cancers. With the
completion of the CLFS pricing process for clonoSEQ, Adaptive plans
to leverage the finalized rate in the process of establishing new
payer agreements, updating existing agreements to include the
clonoSEQ PLA code, and expanding coverage to additional
indications.
About clonoSEQ
clonoSEQ is the first and only FDA-cleared in vitro diagnostic
(IVD) test service to detect minimal residual disease (MRD) in bone
marrow from patients with multiple myeloma (MM) or B-cell acute
lymphoblastic leukemia (B-ALL) and blood or bone marrow from
patients with chronic lymphocytic leukemia (CLL). clonoSEQ testing
for diffuse large B-cell lymphoma (DLBCL) patients is currently
available for clinical use as a laboratory-developed test (LDT)
performed at Adaptive's CLIA-certified lab in Seattle, WA.
clonoSEQ leverages Adaptive Biotechnologies’ proprietary immune
medicine platform to identify and quantify specific DNA sequences
found in malignant cells, allowing clinicians to assess and monitor
MRD during and after treatment. The assay provides standardized,
accurate, and sensitive measurement of MRD that allows physicians
to predict patient outcomes, assess response to treatment, inform
changes in therapy, monitor disease burden over time, and detect
potential relapse early. Clinical practice guidelines in
hematological malignancies recognize that MRD status is a reliable
indicator of clinical outcomes and response to therapy, and
clinical outcomes have been shown to be strongly associated with
MRD levels measured by clonoSEQ in patients diagnosed with CLL, MM,
ALL, DLBCL and MCL.
For important information about the FDA-cleared uses of
clonoSEQ, including the full intended use, limitations, and
detailed performance characteristics, please
visit www.clonoSEQ.com/technical-summary.
About Adaptive BiotechnologiesAdaptive
Biotechnologies (“we” or “our”) is a commercial-stage biotechnology
company focused on harnessing the inherent biology of the adaptive
immune system to transform the diagnosis and treatment of disease.
We believe the adaptive immune system is nature’s most finely tuned
diagnostic and therapeutic for most diseases, but the inability to
decode it has prevented the medical community from fully leveraging
its capabilities. Our proprietary immune medicine platform reveals
and translates the massive genetics of the adaptive immune system
with scale, precision and speed. We apply our platform to partner
with biopharmaceutical companies, inform drug development, and
develop clinical diagnostics across our two business areas: Minimal
Residual Disease (MRD) and Immune Medicine. Our commercial products
and clinical pipeline enable the diagnosis, monitoring, and
treatment of diseases such as cancer, autoimmune disorders, and
infectious diseases. Our goal is to develop and commercialize
immune-driven clinical products tailored to each individual
patient.
Forward Looking Statements This press release
contains forward-looking statements that are based on management’s
beliefs and assumptions and on information currently available to
management. All statements contained in this release other than
statements of historical fact are forward-looking statements,
including statements regarding our ability to develop,
commercialize and achieve market acceptance of our current and
planned products and services, our research and development
efforts, and other matters regarding our business strategies, use
of capital, results of operations and financial position, and plans
and objectives for future operations.
In some cases, you can identify forward-looking statements by
the words “may,” “will,” “could,” “would,” “should,” “expect,”
“intend,” “plan,” “anticipate,” “believe,” “estimate,” “predict,”
“project,” “potential,” “continue,” “ongoing” or the negative of
these terms or other comparable terminology, although not all
forward-looking statements contain these words. These statements
involve risks, uncertainties and other factors that may cause
actual results, levels of activity, performance or achievements to
be materially different from the information expressed or implied
by these forward-looking statements. These risks, uncertainties and
other factors are described under "Risk Factors," "Management's
Discussion and Analysis of Financial Condition and Results of
Operations" and elsewhere in the documents we file with
the Securities and Exchange Commission from time to time.
We caution you that forward-looking statements are based on a
combination of facts and factors currently known by us and our
projections regarding the future, about which we cannot be certain.
As a result, the forward-looking statements may not prove to be
accurate. The forward-looking statements in this press release
represent our views as of the date hereof. We undertake no
obligation to update any forward-looking statements for any reason,
except as required by law.
ADAPTIVE INVESTORSKarina Calzadilla, Vice
President, Investor
Relations201-396-1687investors@adaptivebiotech.com
ADAPTIVE MEDIAErica Jones, Associate Corporate
Communications Director206-279-2423media@adaptivebiotech.com
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