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Monday, May 12, 2014 4:46:16 PM
Pricing levels will initially be negotiated directly with the payers based upon a dossier of information, that
may include the following: i) cost analysis of resources required to perform the test (both fixed and
variable); ii) amortization of the R&D investment to develop the test; iii) payment amounts determined by
other payers; iv) a health economic model reflecting the performance of the LymPro test; v) charges,
payment amounts and resources required for tests that may be comparable (crosswalk to other flow
cytometry type test) or otherwise relevant (i.e. gap fill to an imaging tests such as Avid
Radiopharmaceutical’s (now Lilly’s) Amyvid with an estimated $3,000-$5,000 per procedure in the US);
and vi) projected test volume and utilization data. Because private payers often use Medicare as a benchmark when developing their own payment policies the outcome of the Medicare rate setting process
could influence the payment rate set by other payers, consequently it is important to have a
comprehensive strategy in place for commercialization of the test prior to engaging with the payers.
Looking forward, it is anticipated that in the U.S. the emergence of a greater number of Managed Care &
Accountable Care organizations will drive Rx/Dx combination pricing discussions.
http://content.stockpr.com/amarantus/files/pdf/AMBS_LymPro_whitepaper_9may2013_2300.pdf
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