Years of clinical research led to Insightec receiving FDA approval for Exablate Neuro to treat medication-refractory Essential Tremor in 2016. This was the first step, and patients received treatment at the few centers offering it; however, only those with the ability to pay out-of-pocket could afford the procedure.
The next important step for expanding patient access is getting insurers to include this new treatment in their medical coverage policies.
Insightec pursued multiple paths for expanding access, starting with Medicare. The Reimbursement team with the support of physicians, specialty societies and patients worked toward positive coverage decisions with the Local Medicare Administrative Contractors. As of July 2020, MR-guided Focused Ultrasound is covered by Medicare in all 50 states.
With nationwide Medicare coverage secured, the next step is to continue to drive widespread, affordable care by pursuing coverage with private insurers.
Various Blue Cross Blue Shield plans made positive coverage decisions and today, there are 30 plans covering the treatment.
The big news announced in April this year was that Aetna is the first private insurer to approve nationwide coverage of MR-guided Focused Ultrasound for treating medication-refractory Essential Tremor.
Reimbursement often has a considerable impact on widespread adoption and patient access to new and innovative medical treatments. More than 60 Treatment Centers around the world are using Insightec’s Exablate® Neuro platform to treat Essential Tremor patients. The growth of the availability of Focused Ultrasound has contributed to real-world evidence in support of insurance coverage decisions.
If you are interested in finding out if you may be a candidate for focused ultrasound treatment for essential tremor, please click here to take the quiz.