Cambridge Healthtech Institute’s Sixth Annual
Commercialization of Molecular Diagnostics
August 24-25, 2016 | Grand Hyatt Washington| Washington, DC
Launching molecular diagnostics in the marketplace involves expertise in demonstrating the value proposition of the test, meanwhile carefully managing resources and navigating a competitive environment. Rising healthcare costs have led to innovative solutions which include molecular testing matched with targeted therapies, point-of-care testing to provide rapid results for improved patient outcomes, and non-invasive testing options. Attendees can plan to participate in the discussion with expert faculty in the field as they share insights and best practices for handling regulatory approval, reimbursement and clinical adoption to achieve commercial success.
Day 1 | Day 2 | Short Courses | Download Brochure
SC4: Overcoming Challenges to Commercial Success in Molecular Diagnostics
SC5: Establishing the Value of Diagnostic Tests
*Separate registration required
WEDNESDAY, AUGUST 24
10:30 am Registration
12:50 pm Luncheon Presentation (Sponsorship Opportunity Available) or Enjoy Lunch on Your Own
1:25 Ice Cream and Cookie Break in the Exhibit Hall with Poster Viewing
1:50 Chairperson’s Opening Remarks
Bruce Quinn, M.D., Ph.D., Senior Director, Feared Consulting
2:00 PAMA Implementation: Coding, Pricing, and Coverage
Sylvia J. Trujillo, Senior Washington Counsel, American Medical Association (AMA)
An overview of the Medicare Clinical Laboratory Fee Schedule provisions of the Preserving Access to Medicare Act of 2014 (PAMA) concerning coding, data collection and pricing, and coverage provisions. The foregoing will include highlights of coding issues raised by stakeholders, data collection challenges for clinical laboratories (particularly for physician office based laboratories), and possible coverage implications.
2:10 Clinical Laboratory Payment Reform: Implementing Provisions of the Protecting Access to Medicare Act
Marc Hartstein, Director, Hospital and Ambulatory Policy Group, Centers for Medicare & Medicaid Services (CMS)
This session will discuss Medicare reform of the Clinical Laboratory Fee Schedule based on private payer prices. Topics will also include Medicare payment for advanced diagnostic laboratory tests, coding and pricing for new clinical diagnostic laboratory tests and more.
2:20 PAMA Reimbursement: Lessons from Pharma ASP Reporting
Rick Zimmerer, Partner, Life Sciences Advisory Services, KPMG LLP
PAMA’s price reporting and reimbursement system for laboratories was modeled on the ASP system that has applied to Medicare Part B drug reimbursement for over a decade. The laboratory industry has the opportunity to avoid mistakes and apply lessons learned from that program. This session will summarize key similarities and differences and explore key areas where lessons may be applicable.
2:30 PAMA Final Rule: Key Issues for Advanced Diagnostic Laboratory Tests (ADLTs)
Brian P. Carey, Partner, Foley Hoag LLP
An overview of the key provisions in the Medicare Clinical Diagnostic Laboratory Tests Payment System Rulemaking regarding coding, data collection and reporting, rate-setting and coverage for Advanced Diagnostic Laboratory Tests (ADLTs). In particular, the presentation will address time line for PAMA implementation, including payment for New ADLTs at Actual List Charge and annual data collection and reporting.
2:50 PANEL DISCUSSION
3:30 Value Capture Pathways for Advanced Diagnostic Tests
Charles Matthews, Vice President, Boston Healthcare
How can diagnostic innovators achieve reimbursement success in today’s challenge payer environment? Key factors such as clinical positioning, payer value proposition analysis, and clinical utility evidence development approaches, will be highlighted. This presentation will provide insights into how reimbursement planning can be incorporated into test menu and portfolio development to achieve routine optimal payment regardless of the changing coding and payment landscape.
4:00 Refreshment Break in the Exhibit Hall with Poster Viewing
4:45 KEYNOTE PRESENTATION: From Volume to Value in Healthcare: A New Business Model for Diagnostics?
Glenn D. Steele, Jr., M.D., Ph.D., Chairman of the Board & Chief, Corporate Strategy, xG Health Solutions, Inc.
A combination of transformative changes in how health care is delivered and paid for will impact the business models of all stakeholders including device manufacturers and molecular diagnostic companies. As value of care to patients is emphasized, and as more targeted diagnosis and therapy become the norm, where care is given, who gives care, who makes product buy decisions, and how the product’s cost benefit is evaluated will all change.
5:15 Moderator's Remarks:
Harry Glorikian, Healthcare Consultant
- Is bigger better or should panels be more focused?
- How do you differentiate your institution and its treatment approach from others utilizing genomics?
- How is the data being used by the physician and its effect on the patient?
- How does the number of genes affect reimbursement?
Panelists: Tuan Ha-Ngoc, Executive Chairman, Kew Group
Mark S. Boguski, M.D., Ph.D., Founder & CMO, Precision Medicine Network, Inc.
Gyorgy Abel, M.D., Ph.D., Director, Molecular Diagnostics, Immunology & Clinical Chemistry, Laboratory Medicine, Lahey Hospital & Medical Center
Jerry Conway, Vice President, Reimbursement & Payer Strategy, Foundation Medicine
6:15 Close of Day
6:00 Dinner Short Course Registration
Day 1 | Day 2 | Short Courses | Download Brochure
THURSDAY, AUGUST 25
7:30 am Problem-Solving Breakout Discussions with Continental Breakfast
8:25 Moderator’s Opening Remarks
John Hanna, Vice President, Endocrinology, Veracyte, Inc.
The laboratory market is facing a changing payor landscape including consolidation among private payers and Medicare MAC contractors, a greater push for ACO arrangements and P4P incentive programs, and the introduction of laboratory benefit management programs to control molecular diagnostics spend and utilization. Experts in this session will discuss the challenges these dynamics present to labs and manufacturers in participating in payer networks, launching new products, and demonstrating cost-effectiveness as a diagnostic test provider.
8:30 Showing the Value of Diagnostics in ACOs and Risk-Based Payment Models
Donald May, Executive Vice President, Payment & Health Care Delivery Policy, AdvaMed
This talk will review changing pressures on diagnostic manufacturers and labs to show value and evidence to support their test and highlight industry activities to meet these demands head-on by creating a value framework for diagnostics.
8:50 Lab Benefit Management Programs: Can’t Live without Them, but Can We Live with Them?
Lon Castle, M.D., CMO, Molecular Genetics and Personalized Medicine, eviCore healthcare
Securing payment for your diagnostic test used to be simple. You negotiated a contract, you billed for the test and you got paid. Not anymore. Now there are third-party benefit management companies monitoring your billing and coding to determine not only whether or not to pay you, but how much you will be reimbursed. It’s a new world out there, and you need to be prepared. This presentation will cover: Observations on what works—and what doesn’t, billing using molecular diagnostic codes, and what types of billing practices will get your claim stopped in its tracks.
9:10 Q&A with Speakers
9:30 Commercialization of Targeted Therapies Outside of Oncology
Steve Vitale, Managing Director, Diaceutics AIS, Diaceutics Group
With the majority of targeted therapy launches in the marketplace focused on oncology, we hear similar challenges around tumor sample logistics, testing algorithms, and report interpretation, but what's happening outside of oncology? Are we seeing similar trends? And what learnings should we take away to help with targeted launches outside of oncology?
9:45 Collaborations by Design - Manufacturing Frontier for Smart Polymer Parts
Christoph Mauracher, Ph.D., Managing Director, Sony DADC BioSciences GmbH
10:00 Coffee Break in the Exhibit Hall with Poster Viewing
EVIDENCE FOR DIAGNOSTIC TESTS: PERSPECTIVES FROM DECISION MAKERS
10:50 Moderator's Remarks: Andrew C. Fish, J.D., Executive Director, AdvaMedDx
11:00 Regulatory Perspective
Elizabeth A. Mansfield, Ph.D., Director, Personalized Medicine, Office of In Vitro Diagnostics & Radiological Health, FDA CDRH
11:15 What is the Evidence Doctors Want to See?
Luis A. Diaz, M.D., Associate Professor, Oncology, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center
11:30 Too Much? Too Soon?
Mike Barlow, Vice President, Operations, MolDX Executive Lead, Specialty Contracts, Palmetto GBA
In this talk, I will briefly discuss the challenge of addressing the explosion of molecular testing technology and capability along with the new levels data being developed from these tools. Clinicians and payers alike need a better way to assess, or at least filter, the clinical value of the data and the science behind much of it. The entire community needs a better way to leverage the data in a manner that would more effectively align the forces and clear out the ‘noise’.
11:45 PANEL DISCUSSION
12:20 pm The Relevance and Standardization of Clinical Utility
Greg Richard, Senior Vice President, Commercial Services, Interpace Diagnostics
12:50 Luncheon Presentation (Sponsorship Opportunity Available) or Enjoy Lunch on Your Own
1:20 Session Break
2:00 Moderator’s Remarks
John Beeler, Ph.D., Vice President, Business Development, Inivata
- How much content is valuable? How many genes are necessary or ideal in a gene panel? What are oncologists and patients looking for?
- How are Doctors using data to make decisions?
- What is the ideal technology to use? Do you need a comprehensive panel upfront?
- How does cost or regulatory approval factor in?
Regulation: Abraham Tzou, M.D., Medical Officer, FDA
CLIA New York State: Stephanie Shulman, M.P.H., M.S., M.T. (ASCP), Director, Clinical Laboratory Evaluation Program, Wadsworth Center, New York State Department of Health
Policy: Dr. Sean Tunis, CEO, Center for Medical Technology Policy
Oncologist: Liquid Biopsy: Use in Clinical Trials
Barbara A. Conley, M.D., Associate Director, Cancer Diagnosis Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute (Tentative)
Liquid biopsies offer the promise of interrogating a patient’s cancer without a biopsy, as well as being able to longitudinally sample the molecular profile. Potential uses for “liquid biopsy” in clinical trials include initial diagnosis, target-finding (predictive marker), pharmacodynamics assays and ascertaining development of resistance. Qualities of a fit for purpose liquid biopsy for use in clinical trials for cancer drug development will be presented.
Payor: Elaine Jeter, M.D., Contractor & Medical Director, Palmetto GBA LLC
Investor: Eli Casdin, Managing Member, Casdin Capital
4:05 Close of Conference
Day 1 | Day 2 | Short Courses | Download Brochure