BlueCross BlueShield MI and Cambia Health Solutions Expand TMS Access for Depressed Adolescents
Neuronetics, a medical technology company, announced expanded TMS (transcranial magnetic stimulation) access for adolescents aged 15 and older. BlueCross BlueShield (BCBS) of Michigan and Cambia Health Solutions updated their policies following NeuroStar TMS's FDA clearance as a first-line add-on treatment for major depressive disorder (MDD) in adolescents. BCBS Michigan covers 4.9 million lives, while Cambia Health Solutions, through its subsidiaries, covers 2.5 million lives in several states. These policy updates will be effective September 1, 2024. Neuronetics is the first TMS company with FDA clearance for adolescent treatment and a dedicated health policy team.
- Expanded TMS access for adolescents aged 15 and older.
- FDA clearance for NeuroStar TMS as a first-line add-on treatment for adolescents with MDD.
- BCBS Michigan covers 4.9 million lives, ensuring broad access to TMS.
- Cambia Health Solutions covers 2.5 million lives, enhancing TMS availability in multiple states.
- Policy updates effective from September 1, 2024.
- None.
Insights
The recent policy updates by BCBS Michigan and Cambia Health Solutions highlight a significant development in the accessibility of mental health treatments for adolescents. The clearance of NeuroStar TMS by the FDA for use in younger patients aged 15-21 is a noteworthy step, considering that Major Depressive Disorder (MDD) often manifests during adolescence. By expanding access to TMS, these policies can potentially alleviate some of the treatment barriers that adolescents face, providing them with more options for effective management of their condition.
Transcranial Magnetic Stimulation (TMS) is a non-invasive procedure that uses magnetic fields to stimulate neuronal activity in the brain. For adolescents who do not respond well to traditional medications, TMS offers a promising alternative. The expansion of coverage to a younger demographic is likely to lead to increased adoption of TMS, fostering further research and potentially resulting in better refined treatments in the long run.
For investors, it's essential to note that Neuronetics is currently the only company with FDA clearance for adolescent TMS treatment. This exclusivity positions Neuronetics advantageously in the market, potentially driving revenue growth and strengthening its market presence. Moreover, the company's proactive approach in partnering with health payors to advocate for policy updates demonstrates a strategic alignment with market needs, which could build a strong foundation for future developments.
The policy changes announced by BlueCross BlueShield Michigan and Cambia Health Solutions represent a significant business opportunity for Neuronetics. Expanding TMS coverage to adolescents aged 15 and older opens up a previously untapped market segment. BCBS Michigan alone covers 4.9 million lives and Cambia Health Solutions, through its subsidiaries, covers an additional 2.5 million. This broader acceptance could translate into increased utilization of NeuroStar TMS systems, driving demand and boosting sales.
From a market perspective, gaining coverage from major insurers is a strong endorsement of the efficacy and benefits of NeuroStar TMS. It enhances the credibility of the product and encourages other insurers to consider similar coverage updates. This trend could potentially reduce the lag time for reimbursement and make treatment more accessible to a broader patient base.
Investors should also consider the competitive landscape. With Neuronetics holding the unique position of being the only company with FDA clearance for adolescent TMS treatment, it enjoys a first-mover advantage. However, maintaining this edge will require continued innovation and possibly expanding indications to stay ahead of potential competitors who may seek similar approvals.
Updated criteria post-FDA clearance for NeuroStar TMS benefit youth mental health
MALVERN, Pa., July 10, 2024 (GLOBE NEWSWIRE) -- Neuronetics, Inc. (NASDAQ: STIM), a medical technology company focused on designing, developing, and marketing products that improve the quality of life for patients who suffer from neurohealth disorders, announced that updated policies from BlueCross BlueShield (BCBS) of Michigan and Cambia Health Solutions will broaden access to TMS (transcranial magnetic stimulation) by expanding the eligible age range to 15 years and older. These health policy updates come in response to the Company’s recent clearance from the U.S. Food and Drug Administration (FDA) for NeuroStar TMS as a first-line add-on treatment for adolescents aged 15-21 with MDD (major depressive disorder).
BCBS Michigan covers 4.9 million lives in the state of Michigan, and the policy includes TMS access for members 15-70 years of age. Cambia Health Solutions is the parent company of Regence BCBS, Asuris Health, and BridgeSpan Health, which covers 2.5 million lives throughout the states of Washington, Utah, Oregon, and Idaho. The policy allows TMS eligibility for ages consistent with device-specific FDA indication. The effective date for both policies is September 1, 2024.
“Following quickly after NeuroStar’s FDA clearance for adolescents, these policy updates from major commercial insurance payors represent a crucial step forward in mental healthcare,” stated Keith J. Sullivan, President and CEO of Neuronetics, Inc. “Expanding access to NeuroStar TMS for those aged 15 and older marks significant progress towards ensuring young people receive the care they deserve.”
BCBS of Michigan and Cambia’s Regence BCBS join Premera BCBS with official TMS coverage in the BlueCross BlueShield network for this age group. Premera’s policy covers 2.3 million lives across the states of Washington and Alaska. Neuronetics also recently announced a policy change from Humana to address TMS therapy coverage for adolescents.
Neuronetics is the first and only TMS company with this clearance for the treatment of adolescents and the only TMS company in the industry with a dedicated health policy team that partners with both providers and payors to advocate for health policy updates.
For more information about NeuroStar TMS Therapy, please visit www.neurostar.com.
About Adolescent Depression
Adolescent depression is a complex and challenging mental health condition that affects young individuals during the crucial period of adolescence. An estimated 4.3 million U.S. adolescents aged 15-21 are affected by MDDi. Depression amongst adolescents can disrupt crucial aspects of development, such as academic performance, relationships with peers and family members, and overall emotional well-being.
NeuroStar Advanced Therapy is indicated as an adjunct for the treatment of MDD in adolescent patients aged 15-21.
About Neuronetics
Neuronetics, Inc. believes that mental health is as important as physical health. As a global leader in neuroscience, Neuronetics is redefining patient and physician expectations with its NeuroStar Advanced Therapy for Mental Health. NeuroStar is a non-drug, noninvasive treatment that can improve the quality of life for people suffering from neurohealth conditions when traditional medication hasn’t helped. NeuroStar is indicated for the treatment of depressive episodes and for decreasing anxiety symptoms for those who may exhibit comorbid anxiety symptoms in adult patients suffering from MDD and who failed to achieve satisfactory improvement from previous antidepressant medication treatment in the current episode. It is also FDA-cleared as an adjunct for adults with obsessive-compulsive disorder and for adolescent patients aged 15-21 with MDD. NeuroStar Advanced Therapy is the leading TMS treatment for MDD in adults with over 6.4 million treatments delivered. Neuronetics is committed to transforming lives by offering an exceptional treatment that produces extraordinary results. For safety and prescribing information, visit www.neurostar.com.
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iWorld Health Organization, Depression Fact Sheet. https://www.who.int/news-room/fact-sheets/detail/depression.
FAQ
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