Inspire Medical Systems, Inc. Announces Cigna Coverage for Inspire Therapy for the Treatment of Obstructive Sleep Apnea

Rhea-AI Summary

Inspire Medical Systems (NYSE: INSP) announced that Cigna will provide coverage for its Inspire therapy, effective June 15, 2020. This brings the total coverage to 54 policies, now covering over 180 million members, up from 83 million last year. Additionally, Inspire therapy is set to receive Medicare coverage across the U.S. Cigna's policy deems the FDA-approved device medically necessary for treating moderate to severe obstructive sleep apnea under specific conditions. The company anticipates accelerated growth post-COVID-19 due to these developments.

Positive

• Cigna's coverage adds 97 million members to Inspire therapy, increasing total coverage to over 180 million.
• Medicare coverage for Inspire therapy to be implemented soon, broadening market access.
• Expectations of growth as healthcare policies evolve post-COVID-19.

Negative

• None.

MINNEAPOLIS, June 16, 2020 (GLOBE NEWSWIRE) -- Inspire Medical Systems, Inc. (NYSE: INSP) ("Inspire"), a medical technology company focused on the development and commercialization of innovative and minimally invasive solutions for patients with obstructive sleep apnea (“OSA”), announced today that Cigna, one of the leading health plans in the United States, will provide coverage for the Company’s Inspire therapy, effective June 15, 2020.  Cigna Corporation is a global health service company that provides health insurance coverage for approximately 16 million members in the U.S.

“We are very pleased to receive this positive coverage decision from Cigna.  As health plans continue to update their coverage policies to include Inspire therapy, an increasing number of patients and physicians will have access to our innovative therapy,” said Tim Herbert, President and Chief Executive Officer of Inspire Medical Systems. “With the addition of Cigna, we now have 54 coverage policies, representing over 180 million members, that cover Inspire therapy, compared to 83 million members just one year ago.”

In addition to the 54 commercial coverage policies, Inspire therapy will soon have Medicare coverage across the entire United States. The final Medicare Administrative Contractor (“MAC”), Palmetto GBA, LLC (“Palmetto”), announced its final Local Coverage Decision (“LCD”) policy date release of June 21, 2020, for covering Inspire therapy. 

“Importantly, the Cigna policy and all of the Medicare LCD policies became, or will become, effective during the COVID-19 pandemic, and we anticipate that these collective policies position us well to further accelerate growth once the impact of COVID-19 subsides,” concluded Mr. Herbert.

Under its policy, Cigna considers Inspire’s U.S. Food and Drug Administration (“FDA”) approved hypoglossal nerve neurostimulation device to be medically necessary for the treatment of moderate to severe OSA when specified criteria are met, including a previous attempt at continuous positive airway pressure (“CPAP”) treatment.

About Inspire Medical Systems

Inspire is a medical technology company focused on the development and commercialization of innovative and minimally invasive solutions for patients with obstructive sleep apnea. Inspire’s proprietary Inspire therapy is the first and only FDA-approved neurostimulation technology that provides a safe and effective treatment for moderate to severe obstructive sleep apnea.

For additional information about Inspire, please visit www.inspiresleep.com.

Forward Looking Statements

This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995.  All statements other than statements of historical facts are forward-looking statements, including, without limitation, statements regarding the expected growth in our business following the impact of COVID-19, the release date of the Palmetto final LCD and improvements in market access.  In some cases, you can identify forward-looking statements by terms such as ‘‘may,’’ ‘‘will,’’ ‘‘should,’’ ‘‘expect,’’ ‘‘plan,’’ ‘‘anticipate,’’ ‘‘could,’’ “future,” “outlook,” “guidance,” ‘‘intend,’’ ‘‘target,’’ ‘‘project,’’ ‘‘contemplate,’’ ‘‘believe,’’ ‘‘estimate,’’ ‘‘predict,’’ ‘‘potential,’’ ‘‘continue,’’ or the negative of these terms or other similar expressions, although not all forward-looking statements contain these words.

These forward-looking statements are based on management’s current expectations and involve known and unknown risks and uncertainties that may cause our actual results, performance or achievements to be materially different from any future results, performance or achievements expressed or implied by the forward-looking statements. Such risks and uncertainties include, among others, estimates regarding the annual total addressable market for our Inspire therapy in the U.S. and our market opportunity outside the U.S.; future results of operations, financial position, research and development costs, capital requirements and our needs for additional financing; commercial success and market acceptance of our Inspire therapy; the impact of the ongoing and global COVID-19 pandemic; and general and international economic, political, and other risks, including currency and stock market fluctuations and the uncertain economic environment. Other important factors that could cause actual results, performance or achievements to differ materially from those contemplated in this press release can be found under the captions “Risk Factors” and "Management's Discussion and Analysis of Financial Condition and Results of Operations“ in our Annual Report on Form 10-K for the fiscal year ended December 31, 2019, as updated in our Quarterly Report on Form 10-Q for the quarter ended March 31, 2020, and as such factors may be updated from time to time in our other filings with the SEC, which are accessible on the SEC’s website at www.sec.gov  and the Investors page of our website at www.inspiresleep.com. These and other important factors could cause actual results to differ materially from those indicated by the forward-looking statements made in this press release. Any such forward-looking statements represent management’s estimates as of the date of this press release. While we may elect to update such forward-looking statements at some point in the future, unless required by applicable law, we disclaim any obligation to do so, even if subsequent events cause our views to change. Thus, one should not assume that our silence over time means that actual events are bearing out as expressed or implied in such forward-looking statements. These forward-looking statements should not be relied upon as representing our views as of any date subsequent to the date of this press release.

Investor & Media Contact:
Bob Yedid
LifeSci Advisors
646-597-6989
Bob@LifeSciAdvisors.com 

FAQ

What is the impact of Cigna's coverage decision on Inspire Medical Systems?

Cigna's decision expands Inspire therapy access to an additional 97 million members, enhancing market potential.

How many total coverage policies does Inspire therapy have as of June 2020?

As of June 2020, Inspire therapy has 54 coverage policies covering over 180 million members.

When did Cigna's coverage for Inspire therapy become effective?

Cigna's coverage for Inspire therapy became effective on June 15, 2020.

What criteria does Cigna require for Inspire therapy coverage?

Cigna considers Inspire's device medically necessary for moderate to severe obstructive sleep apnea after previous CPAP attempts.

Is Medicare coverage for Inspire therapy available across the U.S.?

Yes, Inspire therapy will soon have Medicare coverage across the entire United States.