New FDA Approval for IMBRUVICA

SUNNYVALE, CA, July 28, 2014 -- Pharmacyclics, Inc. (NASDAQ: PCYC) today announced that the U.S. Food and Drug Administration (FDA) has granted IMBRUVICA® (ibrutinib) regular (full) approval for the treatment of patients with chronic lymphocytic leukemia (CLL) who have received at least one prior therapy, and for the treatment of CLL patients with deletion of the short arm of chromosome 17 (del 17p CLL), including treatment naïve and previously treated del 17p CLL patients. 

Click Here to read the press release from Pharmacyclics. 

Click Here for the prescribing information.

Important Update from Noridian on Claims for Xoifigo

On July 16, 2014 Noridian posted the following important notice regarding claims for Xoifigo:

Claims with a date of service of September 1, 2014 or after, Noridian will begin requiring submission of the invoice price for payment for Radium 223 (Xoifigo). This radiopharmaceutical should be billed with A9699 when billing from the Medicare Physician Fee Schedule on a CMS-1500 Claim Form or electronically.

Providers must enter the name and dose of the radiopharmaceutical along with the invoice price in Item 19 of the CMS-1500 Claim Form or the electronic equivalent. Claims without this information will be denied as unprocessable.

Click Here to access this notice on the Noridian Website.

ASCO Survey - Be Counted

Be Counted in 2014 ASCO National Oncology Census – No Login Information Required

Please be counted in this year’s ASCO National Oncology Census – the only annual survey of the entire oncology community that aims to capture and describe changes in cancer care over time. The data and insights we obtained from the 2013 census are chronicled in ASCO’s The State of Cancer Care in America: 2014 and are driving ASCO’s policy and advocacy efforts.   New This Year: The 2014 survey tool does not require user IDs or passwords so you can click here and be counted immediately.

Oncotype DX New Study Results

DCIS - Genomic Health Announces Positive Topline Results of Second Large, Independent Validation Study of Oncotype DX® in DCIS Breast Cancer

Complete Data to be Submitted for Presentation at the 2014 San Antonio Breast Cancer Symposium

REDWOOD CITY, Calif., June 11, 2014 /PRNewswire/ -- Genomic Health, Inc. (Nasdaq: GHDX) today announced positive preliminary results from a second large, independent clinical validation study of Oncotype DX® in patients with a pre-invasive form of breast cancer, also known as DCIS (ductal carcinoma in situ).

The study, conducted by the Ontario DCIS Study Group in Canada, met its primary endpoint by demonstrating that the Oncotype DX DCIS Score™ predicts the risk of local recurrence, defined as either the development of a new invasive breast cancer or the recurrence of DCIS in the same breast.

New Premera G-CSF Policy

Premera has posted a new G-CSF policy on their Website. The policy which is effective August 30, 2014 describes the conditions under which Tbo-filgrastim (Granix®),  Filgrastim (Neupogen®) and Pegfilgrastim (Neulasta®) may be considered medically necessary and covered.  

Please take the time to read the policy and policy guidelines on the Premera Website:

New FDA Approval for Cyramza

On April 21, 2014, the FDA approved Lilly’s Cyramza (ramucirumab) to treat patients with advanced stomach cancer or gastroesophageal junction adenocarcinoma, a form of cancer located in the region where the esophagus joins the stomach. 

Cyramza is an angiogenesis inhibitor that blocks the blood supply to tumors. It is intended for patients whose cancer cannot be surgically removed (unresectable) or has spread (metastatic) after being treated with a fluoropyrimidine- or platinum-containing therapy.

For more information and to access the FDA press release:

Clinical and reimbursement information is available at:


New FDA Approval for Vectibix

On May 23, 2014 the Food and Drug Administration (FDA) approved a new indication for Vectibix® (panitumumab) as follows: 

Vectibix® is indicated for the treatment of patients with wild-type KRAS (exon 2 in codons 12 or 13) metastatic colorectal cancer (mCRC) as determined by an FDA-approved test for this use:

  • As first-line therapy in combination with FOLFOX
  • As monotherapy following disease progression after prior treatment with fluoropyrimidine-, oxaliplatin-, and irinotecan-containing chemotherapy

Vectibix® is not indicated for the treatment of patients with KRAS-mutant mCRC or for whom KRAS mutation status is unknown.  

Please click here to link to the Vectibix® Prescribing Information (PI), including Boxed WARNING.



On March 31, Congress passed another temporary fix to the flawed sustainable growth rate (SGR) formula. This is the 17th temporary fix to the SGR formula. The bill, Protecting Access to Medicare Act of 2014 (H.R. 4302) is expected to be signed by President Obama and would delay until March 2015 the pending 24% cut to Medicare physician payments.

Among other provisions, the bill includes:

  • A 12-month patch for the SGR and continues the 0.5% update through calendar year 2014 and a zero percent payment update from January 1, 2015 to March 31, 2015;
  • An extension of the work GPCI floor until April 1, 2015;
  • A minimum 1-year delay (the bill language states HHS may not adopt ICD-10 as the standard code set until October 1, 2015) in transition from ICD–9 to ICD–10 code sets;
  • The establishment of a market-based payment system for diagnostics under the Clinical Laboratory Fee Schedule (CLFS);
  • Development of quality incentives, including penalties for certain computed tomography services to improve radiation dosing safety  and to promote the use of appropriate use criteria (AUC) for advanced diagnostic imaging.;
  • A delay of the Recovery Audit Contractor enforcement of the “two-midnight rule” through March 31, 2015;
  • A new skilled nursing facility value based purchasing program (SNF VBP) to begin in fiscal year 2019;
  • An extension of the Qualifying Individual (QI) Program that assists Medicare beneficiaries with incomes between 120%-135% of the federal poverty level (FPL) by covering the cost of their Medicare Part B premiums.