United Healthcare Issues Positive Coverage Decision for Cxbladder

Pacific Edge Limited is pleased to advise that its Cxbladder bladder cancer diagnostic tests are now covered by United Healthcare, the largest healthcare group in the US.

Effective from 1 April 2021, Cxbladder is now being covered as a ‘medically necessary bladder tumor marker test’, under United Healthcare’s Molecular Pathology/Molecular Diagnostics/Genetic Testing (Medicare Advantage) - Medical Policy.

United Healthcare has over 50 million members with more than 5.7 million Medicare Advantage members. In 2019, UnitedHealth Group had a 14.1 percent share of the U.S. health insurance market, with direct premiums written amounting to approximately US$107 billion . The organisation partners with 6,500 hospitals and care facilities nationwide, and more than 1.3 million physicians and other providers.

Including the positive coverage decision issued by the Centres for Medicare and Medicaid Services (CMS) in 2020, more than 110 million Americans now have coverage of Cxbladder non-invasive, highly accurate tests for the detection and management of urothelial and bladder cancer.

Pacific Edge CEO David Darling states: “Gaining coverage with the US’ largest insurer is a significant achievement for Pacific Edge and will be of benefit to millions of Americans seeking better clinical solutions and health outcomes for bladder cancer diagnosis.

“This positive coverage decision reflects the validation that comes from independent published clinical evidence, inclusion in guidelines and coverage with other providers such as the CMS. It adds further validation of Cxbladder and a point of inflexion for other healthcare insurers.”

Jackie Walker, the CEO of PEDUSA, Pacific Edge’s US business, said: “Over the last six months, we have been expanding our US sales team to deliver on the growth opportunities available to Cxbladder. These specialist sales people will now be working closely with urologists associated with United Healthcare to encourage and support them in their use of our Cxbladder products.”