Omeros launches OMIDRIAssure program to provide expanded patient access to Omidria

Oct 15 2015

Omeros Corporation (NASDAQ: OMER) today announced that it has launched OMIDRIAssure^™, a comprehensive reimbursement services program to provide expanded access to Omidria^® (phenylephrine and ketorolac injection) 1% / 0.3% for cataract surgery patients and reimbursement assistance for physicians and facilities. The program services include the:

• OMIDRIAssure Information Hotline for physicians and facilities seeking personalized help and information on Omidria coverage and reimbursement;
• "Equal Access" Patient Assistance Program providing assistance to financially eligible uninsured or government-insured patients; and
• "We Pay the Difference" Commercial Reimbursement Program providing assistance to patients with insufficient commercial insurance.

Omidria is the first and only FDA-approved intraocular product that both prevents intraoperative miosis and reduces postoperative ocular pain. Omidria was granted transitional pass-through reimbursement status by the Centers for Medicare and Medicaid Services (CMS) and is reimbursed by CMS separately, and in addition to, the packaged payment for cataract surgery and lens replacement procedures.

Although just recently launched, Omidria already is covered by 100 percent of Medicare Administrative Contractors and by Medicare Advantage plans at typically the same rate as Medicare Part B. The drug has confirmed coverage for 145 million of the 155 million lives insured by the top 30 U.S. commercial payers including Aetna, Cigna, Anthem/WellPoint, Humana, UnitedHealthcare and Kaiser Permanente. American Association of Retired Persons (AARP), USAA, TRICARE and a large number of Blue Cross/Blue Shield regional carriers also reimburse for Omidria.

The OMIDRIAssure coverage and reimbursement support services for surgeons and facilities remove uncertainties about coding, billing, and coverage of Omidria. The "Equal Access" Patient Assistance and the "We Pay the Difference" Commercial Reimbursement Programs remove patients' financial barriers to accessing the drug. Under the "Equal Access" program, financially eligible uninsured and government-insured patients receive Omidria free of charge for use during surgery. For commercially insured patients, Omeros through its "We Pay the Difference" program pays the facility, on behalf of the patient, the difference between the facility's acquisition cost for Omidria and the amount covered by the patient's insurance less a $30 patient responsibility.

"The clinical benefits of Omidria are clear and, together with the rapid adoption of Omidria by insurance carriers and its nearly universal coverage to date, Omidria is gaining market acceptance," stated Gregory A. Demopulos, MD, chairman and chief executive officer of Omeros. "OMIDRIAssure provides patients, physicians and facilities with further confidence that there are no financial or administrative barriers to incorporating FDA-approved Omidria across routine and complex procedures. All cataract surgery patients deserve -- and now can access -- Omidria."