Latest Us Commercial Payers News

Pacific Edge has secured final Medicare coverage for Cxbladder Triage and Triage Plus in intermediate-risk microhematuria, with the policy due to take effect on 20 December. The decision gives the company a clearer reimbursement pathway, but revenue gains still depend on adoption and testing volumes.

Pacific Edge has secured new US payer access and a Veterans Administration purchasing agreement while proposed Medicare price increases could materially lift revenue per test. The recovery remains unfinished, however, with US commercial volumes down 13% and final Medicare coverage still pending.

Pacific Edge’s draft Medicare Local Coverage Determination for its Cxbladder bladder cancer tests marks a pivotal step toward unlocking a $10.2 billion global market. Despite FY26 setbacks, the company is poised for growth with improved reimbursement prospects and strategic cost management.

Pacific Edge reported a 2.7% increase in test volumes for Q4 2026 despite operational challenges, supported by growing momentum toward Medicare coverage and expanded commercial payer adoption in the US and Asia Pacific.

Botanix Pharmaceuticals has initiated the commercial rollout of Sofdra, its FDA-approved treatment for primary axillary hyperhidrosis, with first prescriptions dispensed and a fully trained sales force deployed. The company anticipates meaningful revenue growth starting in the first quarter of 2025, backed by strong payer contracts and a robust cash position.