Scipher Medicine Receives Medicare Coverage for PrismRA® Test in Rheumatoid Arthritis Patients

2023-09-07

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WALTHAM, Mass.--(BUSINESS WIRE)-- Scipher Medicine Corporation, a precision immunology company matching each patient with their most effective therapy, today announced that Palmetto GBA, a Medicare Administrative Contractor (MAC), and Centers for Medicare and Medicaid Services (CMS) published a local coverage determination (LCD) for molecular biomarker testing to guide targeted therapy selection in rheumatoid arthritis (RA) patients. The coverage decision includes PrismRA, Scipher’s innovative molecular diagnostic test that guides treatment selection for patients with RA. The LCD identifies evidence supporting the clinical utility of PrismRA and clinical studies show that when PrismRA guides therapy selection, patients are three (3) times more likely to reach remission. The LCD provides Medicare coverage for adult patients with RA who are in moderate or high disease activity and have failed first-line therapy for treatment of RA and have not yet initiated a biologic or targeted synthetic therapy (b/tsDMARD) or who have initiated a b/tsDMARD therapy and are being considered for an alternate class of targeted therapy as a result of failure to initial targeted treatment. “Precision medicine will now be accessible to many patients suffering from rheumatoid arthritis, a potentially debilitating disease if not treated with the right therapy,” Scipher Medicine CEO Alif Saleh said. “This coverage decision not only represents a significant benefit for patients today but also ushers in a new era of precision medicine in autoimmune diseases.” Access to PrismRA will benefit eligible patients within Medicare who covers approximately 66 million lives in the United States. About PrismRA® PrismRA is a revolutionary blood test bringing precision medicine to the treatment of rheumatoid arthritis, which affects 20 million patients globally. From a routine blood draw, the PrismRA test analyzes an individual’s molecular signature, helping identify who is unlikely to adequately respond to TNFi therapy, the world’s largest selling drug class, so non-responders can be prescribed alternative effective therapy and avoid unnecessary dose escalations or drug cycles. Providers now have objective data to inform therapeutic decision-making and give patients the best chance of achieving treatment targets and improving clinical outcomes. For more information, please visit PrismRA.com. About Scipher Medicine Scipher Medicine, a precision immunology company matching each patient with their most effective therapy, believes that patients deserve simple answers to treatment options based on scientific data. Using Spectra™, a proprietary network medicine platform, Scipher commercializes tests revealing a person’s unique molecular disease signature and match it to the most effective therapy, ensuring optimal treatment from day one. The patient molecular data generated from our tests further supports the discovery and development of novel and more effective therapeutics. Scipher partners with leading payers, healthcare providers, and pharmaceutical companies to bring solutions to patients across diseases. To learn more about Scipher visit sciphermedicine.com and follow Scipher Medicine on Facebook, Twitter, and LinkedIn.

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