Thermo Fisher Scientific Korea has canceled news conference scheduled for Tuesday to celebrate insurance benefits for Oncomine Dx Target Test (ODxTT), a next-generation sequencing (NGS) cancer diagnostic kit.
On Nov. 16, the Ministry of Health and Welfare introduced ODxTT’s new virtual navigation device-guided bronchoscopy to gene panel test items based on NGS analysis and added it to its insurance coverage list. The notice was applied from Dec. 1.
ODxTT can screen 23 biomarkers that cause non-small cell lung cancer (NSCLC) by one NGS test. It is a multiple-marker companion test system that also allows for the prescription of three biomarkers – BRAF (B-Raf) mutation gene, EGFR (estimated glomerular filtration rate), and ROS1 (ROSA Proto-Oncogene 1).
ODxTT applies to nurse care institutions that meet requirements on the facility, personnel, equipment, and gene panels, according to the criteria for designating and implementing selective reimbursement. However, they cannot constitute panels by adding other selected genes to the already designated 23.
Patients’ financial burden rate regarding ODxTT after receiving insurance benefits is the same as the existing NGS genetic panel test.
In advanced, metastatic, and recurrent cancers (or stage 3 and stage 4), the self-payment rate of 50 percent is applied. In other cases, 90 percent of the self-burden rate is applied if a doctor's note on medical validity, such as treatment, is attached.
Patients cannot perform duplicate tests with other NGS panel tests; in principle, a one-time test is required for diagnosis. However, an additional one-time reimbursement is possible only in case of recurrence or failure to comply with treatment.
ODxTT’s insurance benefits drew attention as it reaffirmed the importance of the cancer companion diagnosis.
That also explains why Thermo Fisher Scientific Korea had prepared Tuesday’s news conference. However, the company reportedly decided to call off the media event, as there was an internal disagreement on reimbursement standards or amounts less than a week ahead of the scheduled event.
“ODxTT’s reimbursement began on Dec. 12. Still, our global headquarters said that additional internal discussion is needed concerning the product’s insurance benefits. So, we decided to call off the media event,” a company official said.
The reimbursed price of ODxTT in the U.S. was set at $1,950 (about 2.55 million won) in 2020, and a refund will be made depending on detailed reimbursement criteria.
The additional discussion at Thermo Fisher Scientifics headquarters will not change the domestic reimbursement criteria. However, according to industry insiders, the company’s global and Korean marketing strategies may result in some changes, drawing attention to how the company will carry out the product’s domestic PR activities.