Telix Pharmaceuticals Ltd (ASX: TLX) shares are starting the week strongly.
In morning trade, the ASX 200 healthcare stock is up 3% to $22.12.
This leaves the radiopharmaceutical company's shares trading within a whisker of a new record high.
Why is this ASX 200 healthcare stock charging higher?
The catalyst for today's gain has been the release of announcement in relation to some big news from over in the United States.
According to the release, the United States Centers for Medicare & Medicaid Services (CMS) will soon pay separately for specialised diagnostic radiopharmaceuticals for Medicare Fee for Service patients in the hospital outpatient setting, beyond the transitional pass-through payment period.
Telix believes this is a "significant decision" for patients and hospitals, with the change facilitating equitable access to advanced imaging agents for all patients into the future.
The release notes that in 2025, the separate payments under the Hospital Outpatient Prospective Payment System (OPPS) will be based on Mean Unit Cost (MUC), derived from hospital claims data. It will apply to any specialised diagnostic radiopharmaceutical without pass-through status and with a threshold per day cost greater than US$630.
This ensures consistent reimbursement for Medicare Fee for Service patients, following expiry of pass-through status.
The company advised that the new separate payment rule will apply to its key Illuccix product from 1 July 2025 after its pass-through status expires. Importantly, it will also apply to Telix's pipeline of investigational diagnostic imaging agents.
This includes TLX007- CDx, a new product for PSMA imaging of prostate cancer, TLX250-CDx (Zircaix) for kidney cancer imaging, and TLX101-CDx (Pixclara) for brain cancer (glioma) imaging, if approved and reimbursed under CMS, and after pass-through expires.
Management commentary
The ASX 200 healthcare stock's CEO of Precision Medicine, Kevin Richardson, was pleased with the news. He said:
Telix welcomes the decision by CMS to unbundle payments for diagnostic radiopharmaceuticals, as it will provide certainty for patients and physicians seeking access to safe and effective diagnostic radiopharmaceuticals. Moreover, it will promote continued investment in bringing new imaging agents to market across a range of disease states, as there is a clear commercial pathway to recouping the investment in innovation and the significant infrastructure and operational costs of delivering high quality service to patients.
As a leading innovator in precision medicine and diagnostic radiopharmaceuticals, we are pleased to see the reimbursement landscape change in favour of patients. This will ensure continued access to advanced imaging agents that provide meaningful information to drive treatment decisions and outcomes for cancer patients.
