BG Medicine Announces Decision by American Medical Association and Centers for Medicare and Medicaid Services on Analyte-Specific CPT(R) Code and Reimbursement for BGM Galectin-3(R) Test
WALTHAM, Mass., Nov. 7, 2012 (GLOBE NEWSWIRE) -- BG Medicine, Inc. (BGMD), a company focused on the development and commercialization of novel cardiovascular diagnostics, announced today that the Centers for Medicare and Medicaid Services (CMS), in the Final Determination for the Medicare Clinical Laboratory Fee Schedule for 2013, assigned a payment rate for the BGM Galectin-3® test under new analyte-specific Current Procedural Terminology (CPT®) code 82777 effective January 1, 2013. The CMS Final Determination decision comes in response to BG Medicine's request for an analyte-specific CPT code and recommendation that CMS assign a higher payment rate for the new code. CMS did not accept the recommendation for a higher payment rate, however, the payment rate will be crosswalked to the code under which the test is currently paid. The BGM Galectin-3 test is a novel test, which is cleared by the U.S. Food and Drug Administration as an aid in assessing the prognosis of patients with chronic heart failure.
"The BGM Galectin-3 test represents a true and significant advancement for chronic heart failure patients and a critical tool for the physicians who make decisions about their medical care. We will pursue an increased Medicare reimbursement rate for this test for 2014 that, we believe, will more appropriately reflect the value of this important diagnostic test," said Eric Bouvier, president and chief executive officer of BG Medicine. "As we work toward that goal, we're accelerating our efforts to expand commercialization of the BGM Galectin-3 test, supported by the reimbursement already in place."
Studies have shown that 30 50% of chronic heart failure patients suffer from an inherently progressive form of the disease that is mediated by the galectin-3 protein. Due to underlying fibrosis that is believed to be associated with galectin-3, patients with this form of heart failure are more prone to rapidly lose cardiac function and are at an increased risk for hospitalization, re-hospitalization and death.
Even with optimal care, today nearly a quarter of all Medicare heart failure patients are readmitted to the hospital within 30 days, making heart failure a major driver of hospital readmission rates, far ahead of myocardial infarction and pneumonia. Because heart failure patients with elevated galectin-3 are two-to-three times more likely to be readmitted to the hospital within 30 days of discharge, galectin-3 testing is a potentially valuable and cost-effective tool in a hospital's strategy to reduce unplanned readmissions. We believe that identifying those patients at greater risk with galectin-3 testing will enable hospitals and physicians to better direct their intervention strategies and resources to those who need them most, potentially providing a way to improve outcomes while also controlling costs and avoiding penalties imposed by Medicare relating to hospital readmissions.
The BGM Galectin-3 test is the first blood test that can detect elevated levels of the galectin-3 protein, helping physicians better understand the prognosis of patients diagnosed with chronic heart failure as well as what treatments may work best. Galectin-3 testing is indicated for use in patients previously diagnosed with chronic heart failure and cannot be used to diagnose heart failure.
About BG Medicine, Inc.
BG Medicine, Inc. is a life sciences company focused on the discovery, development and commercialization of novel cardiovascular diagnostics to address significant unmet medical needs, improve patient outcomes and contain healthcare costs. The Company's first commercialized product, the BGM Galectin-3® test for use in patients with heart failure, is available in the United States and Europe. BG Medicine is also developing the CardioSCORE TM test, a blood test designed to identify individuals at high risk for near-term major cardiovascular events, such as heart attack and stroke. For additional information about BG Medicine, heart failure and galectin-3 testing, please visit www.bg-medicine.com and www.galectin-3.com .
CPT is a registered trademark of the American Medical Association.
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Special Note Regarding Forward-looking Statements
Certain statements made in this news release contain forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities and Exchange Act of 1934, as amended, that are intended to be covered by the "safe harbor" created by those sections. Forward-looking statements, which are based on certain assumptions and describe our future plans, strategies and expectations, can generally be identified by the use of forward-looking terms such as "believe," "expect," "may," "will," "should," "could," "seek," "intend," "plan," "estimate," "anticipate" or other comparable terms. Forward-looking statements in this news release address our ability to expand commercialization of galectin-3 testing; our belief regarding the potential impact of the CMS decision on future sales of our galectin-3 test; our ability to obtain a higher reimbursement rate for our galectin-3 test; our understanding that heart failure patients with elevated galectin-3 are two-to-three times more likely to be readmitted to the hospital within 30 days of discharge than other heart failure patients; our belief that identifying these high-risk patients through galectin-3 testing is a potentially valuable and cost-effective tool in reducing unplanned readmissions; our belief that identifying patients at greater risk with galectin-3 testing will enable hospitals and physicians to more efficiently and cost-effectively direct intervention strategies and resources; our belief that increased usage of galectin-3 testing by the healthcare system may improve health outcomes and reduce healthcare costs. Forward-looking statements are based on management's current expectations and involve inherent risks and uncertainties which could cause actual results to differ materially from those in the forward-looking statements, as a result of various factors including those risks and uncertainties described in the Risk Factors and in Management's Discussion and Analysis of Financial Condition and Results of Operations sections of our recent filings with the Securities and Exchange Commission, including our most recent Annual Report on Form 10-K and Quarterly Reports on Form 10-Q. We urge you to consider those risks and uncertainties in evaluating our forward-looking statements. We caution readers not to place undue reliance upon any such forward-looking statements, which speak only as of the date made. Except as otherwise required by the federal securities laws, we disclaim any obligation or undertaking to publicly release any updates or revisions to any forward-looking statement contained herein (or elsewhere) to reflect any change in our expectations with regard thereto or any change in events, conditions or circumstances on which any such statement is based.
CONTACT: Chuck Abdalian EVP & Chief Financial Officer (781) 434-0210
Source: BG Medicine Inc. 2012 GlobeNewswire, Inc.