Although we don't believe in timing the market or panicking over market movements, we do like to keep an eye on big changes -- just in case they're material to our investing thesis.
What: Shares of Omeros (OMER -4.98%), a biopharmaceutical company focused on developing therapies to treat disorders and/or inflammation associated with the central nervous system, rocketed higher by as much as 40% after Omidria was granted pass-through reimbursement status by the Centers for Medicare & Medicaid Services.
So what: According to Omeros' press release, Omidria, a medication administered during cataract surgery or intraocular lens replacement and designed to prevent pupil constriction and reduce postoperative pain, was granted pass-through reimbursement status by the CMS which will allow ambulatory surgery centers and other outpatient facilities to bill Medicare and other insurance providers for the drug.
As Omeros notes, "Pass-through status allows for separate payment for new drugs and other medical technologies that meet specific clinical-value and cost requirements." The pass-through will remain in effect for about two to three years after which the CMS and insurers will offer a new reimbursement amount. It will officially begin on Jan. 1, 2015 and will be reimbursed based on the drugs' wholesale acquisition cost of $400 to $500 per single-use vial.
Now what: Why's this such a big deal? Cataract surgeries are fairly common procedures and the granting of a pass-through remibursement ensures that physicians and consumers can bill Medicare or Medicaid for some portion of the procedure. This is especially important for the elderly on Medicare since the risk of needing cataract surgery increases with age.
For Omeros it means potentially quicker adoption of the drug by physicians, and easy access to an aging American patient pool. It'll also likely translate into some rapid growth out of the gate, which shareholders would love to see. However, I'd probably suggest waiting a quarter or two to gauge the success of Omidria's launch before considering Omeros a buy – and keep in mind Omidria isn't even scheduled to launch until early next year.
