Nevro (NYSE:NVRO) announced that Carelon Healthcare plans to expand its spinal cord stimulation (SCS) coverage.
Carelon plans to publish a new interventional pain management policy expanding SCS coverage for painful diabetic neuropathy (PDN). The policy, set to go into effect on April 14, increases PDN patient coverage by nearly 43 million additional lives.
Payers that utilize Carelon Healthcare include Anthem Blue Cross in California; Anthem Blue Cross Blue Shield in Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, New Hampshire, Nevada, New York, Ohio, Virginia, and Wisconsin; AmeriHealth; Empire BCBS; Independence Blue Cross; and various Managed Medicaid plans.
Dr. David Caraway, Nevro chief medical officer, said in a news release that results from the SENZA-PDN trial helped lead to insurance companies validating the therapy by broadening access. Caraway said the company expects its data to serve as the foundation for additional coverage expansions.
“Carelon’s coverage policy expansion is good news for people with painful diabetic neuropathy as it will broaden access to Nevro’s 10 kHz Therapy, the only high-frequency parasthesia-free SCS system FDA-approved to treat PDN,” said Kevin Thornal, president and CEO of Nevro. “This coverage policy expansion is a further testament to Nevro’s approach to expanding payer coverage, combining high-quality clinical trial data and individual case-by-case approvals through patient appeals and external reviews.”
The positive news for Nevro follows last week’s announcement of a 5% workforce reduction amid restructuring at the company.