Respiri breathes easier on US reimbursement
Radiopharmacy companies are not the only ones buoyed by favourable changes to public US reimbursement rules (as we reported on Monday).
Respiratory diseases diagnostics house Respiri (ASX:RSH) says it will also benefit from the American Medical Association’s (AMA’s) proposed changes to reimbursement criteria for remote patient monitoring (RPM) programs.
Respiri’s lead product is Wheezo, an app-based device to detect conditions such as asthma and chronic obstructive pulmonary disorder.
As could be expected, Wheezo is part and parcel of the remote patient management revolution.
Buoyed by the expected changes, the US-focused company today released a prezzo, outlining a total addressable market of 50,000 patients within its current client base and a “sales pipeline” of 250,000 patients.
Respiri currently has 29 clients (service providers) across 2435 patient programs.
In a nutshell, reimbursement will be made available for a lower threshold of two days of patient data collected by Wheezo over a 30-day rolling period, compared with 16 days at present.
The amount of time clinical staff must interact with their patient falls to 11-20 minutes, from 20 minutes currently.
Reimbursement is then available for an additional 10 minutes of “interactive communication”, down from the current 20 minutes.
Respiri is specific about the financial impact, estimating the change will increase the number of reimbursable patients from the current 50-70% to up to 90%.
This should generate an additional US$108,000 a year of revenue for every 1000 remotely-monitored patients, with an expected doubling of monitoring services delivered.
At current reimbursement rates, this “might” increase Respiri’s per-patient monthly fees, from between US$70-90 to between US$140-180.
While the revised reimbursement rates are yet to be finalised, the company says they show that remote patient monitoring services “appear to be part of the reimbursement landscape for the foreseeable future”.
Reimbursement is determined not by the AMA, but the US Centers for Medicare and Medicaid Services (CMS).
But given the AMA’s powerful endorsement, the CMS is expected to implement the changes next year with effect from January 2026.
Respiri shares have been on a tear, having doubled over the last month. This morning they firmed 2.5% to 8.1 cents.
RSH Price at posting:
9.6¢ Sentiment: Hold Disclosure: Not Held
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