Boston Scientific logs Pa. reimbursement win for Alair asthma treatment

A private insurer in Pennsylvania is the latest to cover the Alair asthma treatment from Boston Scientific (NYSE:BSX).

Philadelphia-based Independence Blue Cross said June 24 that it will cover the Alair bronchial thermoplasty treatment, which is designed to use thermal energy to reduce smooth tissue in the lungs to decrease the airways’ ability to constrict.

Boston Scientific added the Alair system to its portfolio when it acquired Asthmatx Inc. for $194 million in Sept. 2010. Alair won FDA approval in April 2010, becoming the first device-based asthma treatment approved by the watchdog agency. But Alair has been dogged by slow uptake among insurers since then.

Independence Blue Cross said it’s the 1st health insurer in Pennsylvania to cover Alair and only the 7th Blue Cross plan  to initiate coverage.

“While the vast majority of people living with asthma are effectively managed with medications and by avoiding triggers, there is a very small minority for whom combination medical therapy is not adequate,” clinical programs & policy VP Dr. Don Liss said in prepared remarks. “Our coverage policy was developed in close consultation with pulmonary specialists at Philadelphia’s leading university medical centers, to whom these patients are referred when conventional therapy has failed. We collaborated with these experts to establish criteria limiting coverage to those situations where there is strong evidence that bronchial thermoplasty is necessary.”

“Independence reviewed the evidence we presented as well as the practical challenges we face when patients are referred to us after failing conventional treatment,” added Dr. Kartik Shenoy of Philly’s Temple University Hospital. “In the right hands, bronchial thermoplasty is a proven and cost-effective treatment that can help improve these patients’ quality of life.”

Independence says it covers 2.5 million people in the Philly area and nearly 9 million in 32 states and the District of Columbia.

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