Lantheus ‘applauds’ CMS rule for specialized diagnostic radiopharmaceuticals

Lantheus (LNTH) Holdings, applauds the Centers for Medicare & Medicaid Services’ final rule for the calendar year 2025 Medicare Hospital Outpatient Prospective Payment System. The rule, announced and detailed on the CMS website late Friday, recognizes the value of and ensures broad patient access to specialized diagnostic radiopharmaceuticals by improving the accuracy of payment amounts for these products. Under the new OPPS rules, previously packaged diagnostic radiopharmaceuticals will now be “unbundled” with payments being made separately for any diagnostic radiopharmaceutical with a per day cost greater than $630. These changes enable innovative diagnostic radiopharmaceuticals, including PYLARIFY, to continue to be paid separately by CMS for traditional Medicare Fee for Service patients in the hospital outpatient setting following the expiry of pass-through payment status. The final rule will go into effect January 1, 2025. “Today’s landmark decision by CMS is a win for broader and more equitable patient access and supports long term innovation in the field of diagnostic radiopharmaceuticals,” said Brian Markison, CEO. “At Lantheus, we applaud all those involved in spearheading reform of the payment structure for these potentially life-altering diagnostic tools for underserved populations with high unmet needs. We remain focused on supporting physicians and hospitals with our diagnostic radiopharmaceuticals to help achieve better patient outcomes for traditional Medicare FFS beneficiaries.”