Bloomberg: Reimbursement woes dog Boston Scientific’s Alair

Boston Scientific (NYSE:BSX) has struggled to get U.S. insurers on board with its Alair bronchial thermoplasty treatment system for asthma patients, according to a new report from Bloomberg Business published last Friday.

Concerns over the risk of complications, the availability of inexpensive asthma drugs and the potential for the disease to clear up on its own are at the heart of what is keeping insurers away, Bloomberg reported.

“Bronchial thermoplasty is considered investigational and not medically necessary for the treatment of asthma. This procedure has real and significant complications and the ongoing concern is the relative safety as compared to the benefit,” Anthem spokesperson Jill Becher told Bloomberg.

Complications can range from congestion that can feel like a severe asthma attack, which is common, to bronchospasm and worsened airway hyper-reactivity. At the more deadly end of the spectrum are punctured lungs or bleeding, Bloomberg said.

Despite these risks, the American College of Allergy, Asthma and Immunology endorsed bronchial thermoplasty using the company’s Alair system earlier this month, and urged insurers to do the same.

A dozen or so small insurers are already covering the method, according to Bloomberg, including Health Care Service Corp. who added the treatment this year.

Earlier this year, incoming Boston Scientific CEO Michael Mahoney predicted that the worldwide market for bronchial thermoplasty will hit $1 billion by 2020, but sales are weak enough that the company doesn’t report them, according to Bloomberg.

“The hurdles that are sometimes put in place of newer technologies are challenging and take a lot of time to clear. We have additional work to convince more and more payers to come on board,” Boston Scientific endoscopy president David Pierce told Bloomberg.

Boston Scientific bought Asthmatx, the creator of the asthma-treating tech, in 2010 for approximately $193.5 million. The Alair system has had CE Mark approval in the European Union and FDA approval for the U.S. since March.

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