Health Care Service Corporation Adds First-Line TMS Coverage for Adolescents

Rhea-AI Summary

Neuronetics, Inc. (NASDAQ: STIM) announced that Health Care Service (HCSC) has expanded access to TMS (transcranial magnetic stimulation) for adolescents 15 and older with major depressive disorder (MDD). This policy update aligns with the recent FDA clearance of NeuroStar TMS Therapy as a first-line add-on treatment for this age group. HCSC, the largest customer-owned health insurer in the U.S., will now cover TMS for adolescents 15-17 as a first-line treatment, without requiring prior medication failure.

The policy update, effective 10/1/2024, affects over 15 million covered lives through BCBS Illinois, Montana, New Mexico, Oklahoma, and Texas. This expansion follows recent policy updates from other major insurers, reflecting growing recognition of the need for earlier access to mental health treatments like NeuroStar TMS for young people.

Positive

• Expanded insurance coverage for NeuroStar TMS Therapy to include adolescents 15-17 years old
• First-line treatment status for adolescents, removing the need for prior medication failure
• Policy update affects over 15 million covered lives across five states
• Aligns with recent FDA clearance for adolescent treatment
• Demonstrates growing recognition and acceptance of TMS therapy for mental health treatment

Negative

• None.

Insights

Healthcare Policy Analyst

This policy update by Health Care Service (HCSC) represents a significant advancement in mental health treatment access for adolescents. By expanding coverage for TMS therapy to those aged 15 and older as a first-line treatment for major depressive disorder (MDD), HCSC is aligning with the FDA's recent clearance of NeuroStar TMS Therapy. This move affects over 15 million covered lives across five states, potentially increasing Neuronetics' market reach substantially. The policy's effectiveness from 10/1/2024 could lead to a notable uptick in NeuroStar TMS Therapy utilization, possibly translating to increased revenue for Neuronetics. Moreover, this policy change, coupled with similar updates from other major insurers like Aetna and California Medicaid, indicates a growing trend in the healthcare industry towards broader acceptance and coverage of TMS therapy. This trend could further solidify Neuronetics' market position and drive long-term growth prospects in the neurohealth sector.

Medical Device Market Analyst

Neuronetics' unique position as the first and only TMS company with FDA clearance for adolescent treatment gives it a significant competitive advantage in the expanding mental health treatment market. The HCSC policy update, covering TMS as a first-line treatment for adolescents 15-17, opens up a new demographic for NeuroStar TMS Therapy. This could lead to increased device sales and recurring revenue from treatment sessions. The company's dedicated health policy team is proving to be a strategic asset, successfully advocating for policy changes that directly benefit its business model. As more insurers follow suit, we could see accelerated adoption of TMS therapy, potentially leading to market expansion and increased valuation for Neuronetics. However, investors should monitor how quickly this translates into tangible financial results, as the policy's implementation date is set for the future (10/1/2024) and market penetration may take time.

Policy update increases access for millions covered by HCSC BlueCross BlueShield policies

MALVERN, Pa., Sept. 25, 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 Health Care Service Corporation (HCSC) has expanded access to TMS (transcranial magnetic stimulation) for adolescents 15 and older with major depressive disorder (MDD). This policy parallels the recent clearance by the Food and Drug Administration for NeuroStar TMS Therapy as a first-line add-on treatment for this age group.

HCSC, a Mutual Legal Reserve Company, is an independent licensee of the BlueCross BlueShield (BCBS) Association and the largest customer-owned health insurer in the United States. The TMS policy, which already covered adults 18+ after two medication trials and psychotherapy, now also covers TMS for adolescents 15-17 as a first-line treatment, meaning that the patient does not need a medication failure prior to starting TMS. Aligned with the FDA clearance for adolescents, the policy specifies TMS use as an add-on, or augmentation with other therapy, such as antidepressant medications. The TMS policy update is effective 10/1/2024 and affects over 15 million covered lives through BCBS Illinois, BCBS Montana, BCBS New Mexico, BCBS Oklahoma, and BCBS Texas.

“This milestone policy by HCSC is a testament to the growing recognition that our young people need earlier access to proven mental health treatments like NeuroStar TMS,” stated Keith J. Sullivan, President and CEO of Neuronetics, Inc. “We commend HCSC for their leadership in patient access, as well as our NeuroStar providers and Health Policy team for their advocacy to create positive change for mental health.”

Neuronetics previously announced updated policies through payors such as Aetna and California Medicaid, highlighting the recent momentum from commercial and government payers to expand coverage for TMS Therapy. In addition to being the first and only TMS company with FDA clearance for adolescent treatment, Neuronetics is 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 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 6.6 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.

Media Contact:
EvolveMKD
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NeuroStar@evolvemkd.com

FAQ

What is the new HCSC policy update for TMS therapy and when does it take effect?

HCSC has expanded TMS coverage to include adolescents 15 and older with major depressive disorder as a first-line add-on treatment. The policy update takes effect on October 1, 2024.

How many covered lives are affected by HCSC's TMS policy update for STIM's NeuroStar therapy?

The TMS policy update affects over 15 million covered lives through BlueCross BlueShield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas.

What is unique about Neuronetics' (STIM) FDA clearance for TMS therapy in adolescents?

Neuronetics is the first and only TMS company with FDA clearance for adolescent treatment, specifically as a first-line add-on treatment for major depressive disorder in patients aged 15 and older.

How does the new HCSC policy change TMS coverage for adolescents with depression?

The new policy allows TMS coverage for adolescents aged 15-17 as a first-line treatment, meaning they don't need to fail medication trials before starting TMS therapy.