Lantheus reaffirms outlook for PYLARIFY’s ‘blockbuster status’ for 2025

Lantheus (LNTH) Holdings notes that the Centers for Medicare & Medicaid Services recently posted updated payment rates in Addendum B related to the final rule for the calendar year 2025 Medicare Hospital Outpatient Prospective Payment System The company said, “The company continues to commend CMS for recognizing the value of and ensuring broad patient access to specialized diagnostic radiopharmaceuticals. With PYLARIFY on track to exceed $1B in sales in 2024, Lantheus reaffirms its 2025 outlook for PYLARIFY as a blockbuster brand that will continue to be the clear standard and #1 ordered PSMA PET imaging agent in the U.S.” 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 diagnostic radiopharmaceuticals, including PYLARIFY, to continue to be paid separately by CMS for the approximately twenty percent of traditional Medicare Fee for Service patients in the hospital outpatient setting following the expiry of pass-through payment status at a rate that reflects mean unit cost. The final rule will go into effect January 1, 2025.