Medicare reimbursement
Frank Leonard, Senior Vice President of Corporate Strategyand Health Policy
a pathway to reach more patients

A partnership with a patient re-energized Novocure on its journey to obtain coverage for Medicare recipients.

Frank Leonard’s first project after joining Novocure became a quest that took nearly a decade to complete.

In 2010, the year before Novocure received its first FDA approval in recurrent GBM, Frank was tasked with determining how Novocure would launch a product commercially. He zeroed in on the fact that Novocure’s cancer therapy did not yet have a classification from a reimbursement standpoint. Eventually, Optune and Tumor Treating Fields became classified as durable medical equipment (DME). This posed a challenge because most DME are simple devices like wheelchairs, canes and walkers, and decision-makers were not used to evaluating advanced therapeutic technologies in the DME space.

After launching its first commercial product, Novocure began working to educate insurers and countries with national reimbursement about the value of Novocure’s therapy. The company also continued to build its data.

Over the years, nearly every major health insurer in the U.S., along with several governments, began reimbursing for Optune. Medicare was the last major healthcare payer in the U.S. that did not reimburse for Novocure’s therapy.

“Going back to the beginning, we were approaching Medicare to introduce an entirely new concept in medicine,” said Frank, Novocure’s Senior Vice President of Corporate Strategy and Health Policy. “There was definitely a point, maybe five years into the process, where it felt like the process may never end.”

In 2016, Frank formed a partnership that helped re-energize him on his journey. He began working with Steve Welhoelter, an Optune patient, to advocate for Medicare reimbursement on Capitol Hill by educating lawmakers on the importance of Novocure’s therapy.

“It made it very real to me, that no matter how long the process took, we had to get all the way through the process to be successful and ensure coverage for our patients,” Frank said.

Steve of Ponce Inlet, Florida, had recently retired. Teaming up with Novocure gave him a renewed sense of purpose. He told his story of living with GBM and receiving Optune therapy to lawmakers and to panels of decision-makers. Steve said he believed in Novocure’s mission and wanted to help ensure the therapy was available to patients who needed it.

“I’m privileged to be a part of a team that cares so much about people,” Steve said.

In July 2019, Medicare released a final local coverage determination providing coverage of Optune for Medicare beneficiaries with newly diagnosed GBM. Frank said it took him two weeks to digest the news.

“Securing Medicare reimbursement was only possible because every department at Novocure contributed to the mission, we worked as a team, and we partnered with our patients,” he said. “Everything had to come together.”