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Biotech Startup Receives Medicare Coverage

Written By Brian Hicks

Posted August 28, 2012

After it recently achieved Medicare coverage of its heart diagnostic test, biotech firm CardioDx Inc. has now lined up $58 million in funding in a two-tranche round that will see it through $30 million now and the remainder later this year.

The current list of backers includes Kleiner Perkins Caulfield & Byers, Mohr Davidow Ventures, GE Capital, TPG Biotech, and newcomer Temasek of Singapore.

CardioDx aims to use the cash to ramp up marketing and sales for its Corus CAD test. The test uses a patient’s blood sample to determine which of 23 critical genes are fully expressed. That information along with age and sex can help determine whether a patient has obstructive coronary artery problems.

While just 10 salespeople currently market the test to cardiologists around the country, the cash influx could double the team. The Corus test costs $1,195 and has been performed over 30,000 times thus far.

From the San Francisco Business Times:

“No matter what form health-care reform takes, it will have a couple of common things,” [CardioDx President and CEO David] Levison said. “One, it will be much better at getting the right therapy to the right patient at the right time — we need to get better at triaging the patients up front. The second piece is to put more care decisions in the hands of the primary physicians and less in the hands of the guys in the emergency room.”

Earlier this year, Medicare contractor Palmetto GBA decided to cover the cost of the Corus test in retroactive fashion; all tests beginning January 1 of this year would receive coverage.

So far, just under 20 percent of the tests have been covered. Prior to the Medicare decision, CardioDx had not aggressively sought coverage as the company wanted to wait until it had a substantial data.

The test is currently marketed in several states including California, Georgia, Ohio, Texas, Pennsylvania, and others.