Exact Sciences Corp, Madison, Wis, announced on March 4 that Aetna, one of the nation’s leading health plans, has agreed to cover the Cologuard test for colorectal cancer screening under its Medicare Advantage plan, reaching 967,000 members across the country. The 3-year agreement will go into effect on April 1, 2015.
The following day, Anthem affiliate Blue Cross Blue Shield of Georgia issued a medical policy position statement, allowing that “Cologuard, a fecal DNA test, is considered medically necessary once every 3 years as a screening technique for individuals in whom colon cancer preventive screening is indicated.” Details about the pricing of the test or the initiation of coverage by other Anthem affiliates were not immediately available.
Available by prescription only, Cologuard is the only FDA-approved noninvasive stool-based DNA (sDNA) screening test for colon cancer. Cologuard offers people 50 years and older who are at average risk for colorectal cancer an easy-to-use screening test that they can do in the privacy of their own home. Unlike many other screening options, Cologuard does not require medication, dietary restrictions, or bowel preparation prior to taking the test. It is the first noninvasive screening test for colorectal cancer that analyzes both sDNA and blood biomarkers to detect cancer and precancer.
Under the Aetna coverage decision, Cologuard will be available to the plan’s Medicare Advantage members through their physician without a copayment or coinsurance. “We look forward to working with Aetna to provide their members with a new option for colon cancer screening,” says Kevin Conroy, JD, chairman and CEO of Exact Sciences. “Colon cancer is most treatable when caught early, underscoring the importance of routine screening.”
Cologuard is included in the colorectal cancer screening guidelines of the American Cancer Society, and stool DNA is included in the U.S. Multi-Society Task Force on Colorectal Cancer. For more information, visit Exact Sciences.