Intersect ENT claims reimbursement win for Propel drug-eluting sinus implant

Intersect ENT (NSDQ:XENT) said today that it won a positive coverage decision from CareFirst BlueCross BlueShield for its Propel and Propel Mini drug-eluting sinus implants.

The devices are designed to elute the anti-inflammatory steroid mometasone furoate; Menlo Park, Calif.-based Intersect won FDA approval for the original Propel implant in August 2011 and for the Propel Mini the following September. The implants are designed to dissolve into the body over time.

CareFirst BlueCross BlueShield has some 3.2 million lives under coverage in Washington, D.C., Maryland and northern Virginia, including more than 577,000 in the Federal Employees Health Program.

“We are thrilled to add CareFirst to the growing list of payors who recognize the clinical and economic value of Propel and Propel Mini in addressing the needs of chronic sinusitis patients,” president & CEO Lisa Earnhardt said in prepared remarks. “This decision reflects continued positive momentum in obtaining favorable reimbursement for Propel.”

The health insurer said it based the decision on clinical studies showing the safety and effectiveness of the Propel treatment.

“Use of a mometasone furoate-eluting sinus implant, such as Propel, is considered medically necessary in conjunction with functional endoscopic sinus surgery (FESS) or other sinus procedure,” according to CareFirst BlueCross BlueShield. “Despite the limitations of the studies, the actions of topically applied corticosteroid drugs in conjunction with FESS are known. The Propel implant is an example of a product that releases a steroid drug safely and effectively over time. Therefore the implant is considered medically necessary when used in accordance with its approved labeling.”

Intersect is also working on a pair of other drug-eluting, bioresorbable implant, 1 called Nova and another called Resolve. The company raised $103 million in an initial public offering back in June 2015.

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