Omeros Corporation (NASDAQ:OMER) has announced the confirmation of a separate ambulatory surgery center payment by the Centres for Medicare & Medicaid Services (CMS) for OMIDRIA®, the company’s cataract surgery drug. OMIDRIA® is a 1%/0.35 phenylephrine and ketorolac intraocular solution.
OMIDRIA qualifies for separate payment in the ASC setting
CMS confirmed that Omero’s OMIDRIA is eligible for separate payment under its non-opioid pain management surgical drugs policy when employed in ASC setup. According to the final rule, this is meant for the Medicare outpatient prospective payment system (OPPS) and the ASC payment system for the 2021 calendar year. The separate OMIDRIA payment became retroactively effective as of October 1, 2020.
Gregory Demopulos, the company’s Chairman and CEO, said that the company appreciates the CMS’s decision for continued separate payment for OMIDRIA. He said that OMIDRIA has come off the pass-through status. This will be the first time the ophthalmic drug will be eligible per the CMS payment policy for non-opioid pain management surgical treatments ASC setup. Besides reducing patient opioid exposure, the CMS’s decision will continue offering critical access to the drug from medical beneficiaries. It will also enable ophthalmic surgeons to employ the best medical judgment when treating patients. Demopulos added that this is a great outcome for surgeons, patients, and surgical facilities.
OMIDRIA only approved cataract replacement surgery drug
It is important to note that OMIDRIA is the only and first FDA-approved drug for use during lens or cataract replacement surgery. The drug prevents pupil constriction during surgery and also minimizes postoperative ocular pain. According to post-marketing studies, OMIDRIA has demonstrated a wide range of benefits that include sight-threatening complications reductions and mitigation of the need for post- and intraoperative steroids. Currently, OMIDRIA has approval for use in children and adults.
OMIDRIA is also currently the only NSAID-containing product approved by the FDA for intraocular use. Interestingly, post-launch studies in femtosecond laser-assisted and conventional cataract surgery have shown that OMIDRIA can prevent intraoperative floppy iritis prolapse and iris syndrome. It can also reduce complications that include breakthrough iritis and sight-threatening cystoid macular edema.