Nevro Announces Multiple Positive Coverage Updates for the Treatment of Painful Diabetic Neuropathy

Rhea-AI Summary

Nevro Corp. announced that Aetna has updated its spinal cord stimulation (SCS) coverage to include painful diabetic neuropathy (PDN), effective August 29, 2022. This policy change benefits approximately 22 million commercial lives. Additionally, proposed local coverage determinations from Novitas and First Coast could expand Medicare coverage for PDN, affecting around 17 million Medicare beneficiaries. Overall, this could increase coverage for PDN patients in the U.S. from 54% to approximately 66% if finalized. These advancements enhance access to Nevro's proprietary 10 kHz Therapy for chronic pain treatment.

Positive

• Aetna's updated policy covering PDN provides access to approximately 22 million commercial patients.
• Proposed local coverage determinations may increase Medicare coverage for PDN by an additional 17 million patients.
• Coverage for PDN patients in the U.S. could rise from 54% to around 66% if finalized.

Negative

• None.

Aetna Updates Spinal Cord Stimulation Coverage Policy to Include Painful Diabetic Neuropathy Effective Immediately

Medicare Administrative Carriers Novitas and First Coast Propose Positive Local Coverage Determinations

REDWOOD CITY, Calif., Sept. 1, 2022 /PRNewswire/ -- Nevro Corp. (NYSE: NVRO), a global medical device company that is delivering comprehensive, life-changing solutions for the treatment of chronic pain, today announced that Aetna has updated their spinal cord stimulation (SCS) coverage policy to explicitly cover painful diabetic neuropathy (PDN), effective August 29, 2022.  Aetna is one of the largest health plans in the US covering approximately 22 million commercial lives.

Nevro also announced that Novitas and First Coast, the Medicare Administrative Contractors (MACs) that represent Arkansas, Colorado, Delaware, Florida, Louisiana, Maryland, Mississippi, New Jersey, New Mexico, Oklahoma, Pennsylvania and Texas, published their draft Local Coverage Determinations (LCDs) titled, "Nerve Stimulators for Chronic Intractable Pain", which propose updated coverage criteria to include PDN refractory to conventional medical management for SCS devices with an explicit FDA approval to treat PDN.  If finalized, these LCDs will mean that Medicare patients in all 50 states will enjoy coverage for PDN and will add approximately 17 million covered Medicare lives.  The review of these proposed LCDs is ongoing and potential finalization dates have not yet been determined.

"These are very positive coverage advancements for the significant number of commercial and Medicare patients covered by these carriers, which will provide greater access to Nevro's proprietary 10 kHz Therapy for PDN patients," stated D. Keith Grossman, Chairman, CEO and President of Nevro.  "I am particularly pleased with the coverage decision by Aetna, who reconsidered its decision from earlier in the year and changed its SCS coverage policy to explicitly cover painful diabetic neuropathy." 

Mr. Grossman continued, "Our reimbursement team is continuing to work closely with payers to provide the published clinical literature for 10 kHz Therapy and to respond to any questions raised during their policy reviews.  We believe our strong and growing body of published, peer-reviewed clinical and real-world data will be the basis for further coverage decisions by other major health plans in 2022 and beyond."   

This update from Aetna, coupled with the other recent positive coverage decisions from UnitedHealthcare, Blue Cross Blue Shield and Noridian, increases coverage in the US to approximately 54% of PDN patients, up from approximately 25% of patients at the end of 2021.  If finalized, the Medicare MAC coverage policies from Novitas and First Coast are expected to increase coverage in the US to approximately 66% of PDN patients. 

Internet Posting of Information

Nevro routinely posts information that may be important to investors in the "Investor Relations" section of its website at www.nevro.com.  The company encourages investors and potential investors to consult the Nevro website regularly for important information about Nevro.

About Nevro

Headquartered in Redwood City, California, Nevro is a global medical device company focused on delivering comprehensive, life-changing solutions that continue to set the standard for enduring patient outcomes in chronic pain treatment. The company started with a simple mission to help more patients suffering from debilitating pain and developed its proprietary 10 kHz Therapy, an evidence-based, non-pharmacologic innovation that has impacted the lives of more than 80,000 patients globally. Nevro's comprehensive HFX™ spinal cord stimulation (SCS) platform includes a Senza SCS system and support services for the treatment of chronic trunk and limb pain and painful diabetic neuropathy.  Senza®, Senza II®, and Senza Omnia™ are the only SCS systems that deliver Nevro's proprietary 10 kHz Therapy. Nevro's unique support services provide every patient with an HFX Coach™ throughout their pain relief journey and every physician with HFX Cloud™ insights for enhanced patient and practice management.

The Senza® System, Senza II™ System, and the Senza® Omnia™ System are the only SCS systems that deliver Nevro's proprietary 10 kHz Therapy. Senza, Senza II, Senza Omnia, HFX, HXF Coach, HFX Cloud, HFX Connect, Nevro and the Nevro logo are trademarks of Nevro Corp.

To learn more about Nevro, connect with us on LinkedIn, Twitter, Facebook and Instagram.

Forward-Looking Statements  

In addition to historical information, this press release contains forward-looking statements reflecting the company's current beliefs and expectations of management made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, including: our belief that this coverage update will provide greater access to Nevro's proprietary 10 kHz Therapy for PDN patients; and our belief that our strong and growing body of published, peer-reviewed clinical and real-world data will be the basis for further coverage decisions by other major health plans in 2022 and beyond.  These forward-looking statements are based upon information that is currently available to us or our current expectations, speak only as of the date hereof, and are subject to numerous risks and uncertainties, including our ability to successfully commercialize our products; our ability to manufacture our products to meet demand; the level and availability of third-party payor reimbursement for our products; our ability to effectively manage our anticipated growth and the costs and expenses of operating our business; our ability to protect our intellectual property rights and proprietary technologies; our ability to operate our business without infringing the intellectual property rights and proprietary technology of third parties; competition in our industry; additional capital and credit availability; our ability to attract and retain qualified personnel; and product liability claims.  These factors, together with those that are described in greater detail in our Annual Report on Form 10-K filed on February 23, 2022, as well as any reports that we may file with the Securities and Exchange Commission in the future, may cause our actual results, performance or achievements to differ materially and adversely from those anticipated or implied by our forward-looking statements.  We expressly disclaim any obligation, except as required by law, or undertaking to update or revise any such forward-looking statements.

Investors and Media:
Julie Dewey, IRC
Nevro Corp.
Chief Corp Communications and Investor Relations Officer
650-433-3247  |  julie.dewey@nevro.com 

 

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SOURCE Nevro Corp.

FAQ

What changes did Aetna make to its coverage policy for spinal cord stimulation regarding NVRO?

Aetna updated its spinal cord stimulation coverage policy to include painful diabetic neuropathy effective August 29, 2022.

How many patients will benefit from Aetna's updated spinal cord stimulation policy for NVRO?

Approximately 22 million commercial patients will benefit from Aetna's updated coverage policy.

What impact do proposed local coverage determinations have on NVRO?

If finalized, proposed local coverage determinations from Novitas and First Coast could increase Medicare coverage for painful diabetic neuropathy by about 17 million patients.

What is the potential increase in PDN patient coverage in the U.S. due to NVRO's recent developments?

Coverage for painful diabetic neuropathy patients in the U.S. could rise from 54% to approximately 66% if the proposed policies are finalized.