Two U.S. insurers approve coverage of radioembolization for treatment of unresectable liver cancer

Feb 6 2010

Health Insurance Companies Amend Policy on Radioembolization Coverage

MDS Nordion, a global leader in providing products and services for medical imaging and radiotherapeutics, today announced that two of the largest health insurers in the United States have recently approved coverage of radioembolization to treat unresectable liver cancer, which includes the use of MDS Nordion's TheraSphere(R) treatment. The two insurance companies and their affiliates together serve more than one-quarter of Americans and do business in all 50 states.

These changes in policy mark the largest such favorable determinations for reimbursement coverage of radioembolization for liver cancer treatment by U.S. insurers. Medicare and many other commercial insurance carriers also reimburse TheraSphere when medically necessary.

"The decisions by these two large insurers underline the growing acceptance of the role that radioembolization, which includes the use of TheraSphere, plays in the treatment of certain types of liver cancer patients," said Steve West, MDS Inc. CEO.

Radioembolization refers to a process by which small beads or microspheres, containing the radioactive element yttrium-90, are delivered directly to the tumor using the tumor's own blood supply. TheraSphere is one form of radioembolization. Another name for this type of treatment is selective internal radiation therapy (SIRT).

"Radioembolization can offer options to patients who are not eligible for surgery," said Matthew Johnson, MD, Professor of Radiology and Surgery at Indiana University School of Medicine, who offers TheraSphere treatment. "Patients and their families also appreciate that the procedure is performed on an outpatient basis with side effects that are normally milder than many other treatments."

About 22,600 cases of primary liver cancer are diagnosed each year in the U.S., according to the American Cancer Society. About 1 million cases are diagnosed each year globally. The most common form of primary liver cancer is hepatocellular carcinoma (HCC), which in the U.S. is commonly caused by alcohol abuse or by the hepatitis B or hepatitis C virus. HCC is the fifth most common form of cancer in the world and is increasing globally due to an increase in the incidence of hepatitis.

Treatment options for patients with primary liver cancer are limited. HCC is usually unresectable, meaning that it cannot be surgically removed. Unlike TheraSphere, many of the treatments offered for unresectable HCC require inpatient hospitalization and also produce strong side effects that can reduce a patient's quality of life.

"I'm so pleased there will now be major private insurance coverage for TheraSphere," said Suzanne Lindley, a cancer survivor and nationally known patient advocate who heads the YES organization. "Radioembolization was a crucial step in my journey. Now, so many others will be able to take advantage of this procedure."

TheraSphere is typically an outpatient procedure that does not require inpatient hospitalization. It is also well tolerated by patients, with side-effects that are normally milder than with many other treatments for unresectable HCC. Because the procedure is directed to the tumor, there is minimal injury to non-targeted tissue. After treatment, most TheraSphere patients are eligible for further therapeutic options because the procedure preserves liver vascularity.