Boston Scientific lauds private insurance reimbursement coverage for bronchial thermoplasty

Mar 19 2012

Boston Scientific Corporation (NYSE: BSX) welcomes a milestone in private insurance reimbursement coverage for bronchial thermoplasty (BT) performed using the Alair® Bronchial Thermoplasty System.  Minnesota-based HealthPartners and Michigan-based Priority Health recently issued the first public postings of positive insurance coverage policies providing their respective memberships with reimbursement for this novel procedure to treat severe asthma.  These decisions follow the Centers for Medicare and Medicaid Services' decision to make the Alair Catheter eligible for Medicare reimbursement through a separate "pass-through" payment when the procedure is performed in an outpatient hospital setting.

"The recent private payer coverage decisions for bronchial thermoplasty represent positive developments for severe asthmatics and the pulmonary physician community, and should lead to more widespread coverage for this innovative procedure," said David Pierce, President of the Endoscopy Division at Boston Scientific.  "These coverage policies support the CMS payment decisions announced earlier this year and further confirm bronchial thermoplasty as a promising new advancement in the treatment of severe asthma."

Bronchial thermoplasty delivered by the Alair System uses thermal energy to reduce the airway smooth muscle associated with airway constriction in asthma patients.  The results of the AIR2 Trial, published in the January 15, 2010 issue of the American Journal of Respiratory and Critical Care Medicine (AJRCCM) found that in the year following BT, severe asthma patients treated with the Alair System experienced the following benefits:

• 32 percent reduction in severe asthma attacks
• 84 percent reduction in emergency room visits for respiratory symptoms
• 66 percent reduction in days lost from work/school or other activities due to asthma
• Significant improvement in asthma-related quality of life

Data supporting the persistence of the beneficial effects of BT out to at least two years following treatment were published in the July 2011 issue of the Annals of Allergy, Asthma and Immunology.  Additional data supporting the safety of the procedure out to at least five years post-treatment were published in 2011 in the journal BMC Pulmonary Medicine.  The combined published safety and efficacy data for BT supported both payers' decision to cover the procedure for patients with severe persistent asthma who are not well controlled with standard medications.     

The Alair System is a catheter-based device used in BT procedures to treat severe persistent asthma in patients 18 years and older whose asthma is not well controlled with medications.  The product is approved by the U.S. Food and Drug Administration (FDA) and has been available in the U.S. since mid-2010.  While many private insurers have approved BT on a case-by-case basis, the coverage policies from Priority Health and HealthPartners are the first to include their full memberships, totaling about 2 million people.