Exact Sciences ‘will be aggressive’ on lawsuits, CEO says

Exact Sciences CEO Kevin Conroy says his company “will be aggressive” in suing insurers who refuse to cover the company’s colon cancer test.

Though Conroy declined to comment on the two lawsuits so far, he said the company will “fight on behalf of patients” who deserve to have the test covered. That’s especially true, he said, in the 18 states that have laws requiring insurers cover any test that’s part of the American Cancer Society screening guidelines — which include Exact Sciences’ Cologuard test.

“We will do the right thing and let the consequences fall where they may,” he said on an earnings call Wednesday.

Last week, the company filed its second such lawsuit in federal court, suing Blue Cross Blue Shield of North Carolina. The first lawsuit, filed in federal court in Kentucky, was against Humana, one of the nation’s largest insurers.

The lawsuits come as the company is trying to sign contracts with more commercial insurers. The Cologuard test, which analyzes stool samples for abnormal cells that signal colon cancer, is already covered under Medicare and got FDA approval.

The company said yesterday it lost $40 million in the last quarter of 2015, a higher loss than the $32.4 million it lost at the same period of 2014. For the entire year, Exact Sciences lost $157.8 million, compared to $100 million in 2014.

But the number of physicians who ordered the product last quarter was up 27 percent, nearing 27,000. The company said it processed 104,000 Cologuard tests in the entire year and generated $39.4 million in revenues, $14.4 million of that coming in the last quarter.

Last year, Conroy said, was a “strong year” for the company, seen in the amount of physicians who re-ordered the test and high satisfaction rates from physicians and patients. The “true impact,” he said, is how the test is already detecting early stage cancer.

“We’ve begun to fulfill our mission,” he said.

Conroy said he expects further growth in 2016, with the company expanding its contracts with insurers. The company recently announced it’s covering almost half of Anthem’s members through contracts in California, Virginia and Georgia. The company is continuing with targeted multi-platform ads to reach patients.

Its sales team, he said, is also moving beyond selling to single physicians and instead trying to sell to entire practices.

Conroy projected those methods will help Exact Sciences process 240,000 Cologuard tests in 2016, with revenues ranging between $90 million and $100 million.

“We know that we have a great product, we have a correct strategy to reach the physicians and we have a very strong base of physicians who are Cologuard champions, and we have a great sales team,” he said.

The company’s stock closed the day down 8.42 percent, at $5.87 per share.

See an earlier story on the lawsuits

— By Polo Rocha,
WisBusiness.com