Si-Bone today touted that its iFuse implant system has received positive coverage policies from 23 commercial health plans.
The triangular implant designed to treat the sacroiliac joint has now received published exclusive positive coverage policies from Blue Cross Blue Shield plans in Florida, Illinois, New Mexico, Oklahoma, Texas, Montana, Idaho, South Carolina, Kansas, Louisiana, Massachusetts, Minnesota, Mississippi, New Jersey, New York, Tennessee and Wyoming. BCBS Kansas City, Independence, Regence, Capital and Select Health and Amerihealth have also published positive coverage, the company said.
Si-Bone said that in addition to the insurers, EviCore healthcare published a recommendation supporting the device
“Payers continually tell us that long-term outcomes data from well-designed, well-executed randomized controlled trials are critically important when determining coverage for new procedures or technologies. The threshold for positive coverage includes a reliable diagnostic algorithm combined with a broadly adoptable treatment that is safe and clinically effective with a low revision rate and is cost-effective. The iFuse Implant, that’s been available in the U.S. since 2009, has been the subject of 58 peer-reviewed publications demonstrating safety, effectiveness, biomechanical and economic benefits, including two randomized studies. Based on this extensive body of published evidence, many payers have concluded that the iFuse Implant is the only SI joint fusion device that meets the evidence threshold and have established exclusive coverage. We remain committed to continued investments in education and clinical evidence development in order to further expand access to all those who can benefit from surgical treatment of SI joint disorders,” prez & CEO Jeffrey Dunn said in a press release.
In January, Si-Bone said that the Blue Cross Blue Shield Association assigned triangular implants for SI joint fusion, including the company’s iFuse implant, as a “moderate” quality evidence recommendation after an extensive review of safety and effectiveness data on the devices and procedures.
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