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Humana Is First Commercial Payer to Address TMS Therapy Coverage for Adolescents

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Neuronetics (NASDAQ: STIM) announced that Humana is the first commercial payer to update its policy following the recent FDA clearance for NeuroStar TMS therapy for adolescents aged 15-21 with major depressive disorder (MDD). This policy change, effective April 25, 2024, comes just one month after the FDA's March 25, 2024 clearance. Humana's TMS coverage, previously to individuals 18 and older, now includes those aged 15-17, subject to medical director review. Humana covers around 600,000 commercial lives in the U.S. This significant advancement highlights the urgent mental health needs of the adolescent population and reinforces Neuronetics' strategic focus on advocating for health policy updates.

Positive
  • FDA clearance for NeuroStar TMS therapy expands to adolescents aged 15-21.
  • Humana updates its policy within one month of the FDA clearance.
  • Approximately 600,000 lives covered under Humana's updated policy.
  • Neuronetics is the first and only TMS company with this specific clearance.
  • Presence of a dedicated health policy team at Neuronetics facilitates policy updates.
Negative
  • TMS treatment requests for adolescents aged 15-17 require review by a medical director, potentially delaying treatment.

Insights

The recent policy update by Humana to cover NeuroStar TMS therapy for adolescents aged 15-17 is a significant development in the medical technology sector. This change follows the FDA's clearance of NeuroStar TMS for this age group, addressing a critical gap in mental health treatment options for adolescents with Major Depressive Disorder (MDD). Transcranial Magnetic Stimulation (TMS) is a non-invasive method that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. The inclusion of younger patients could lead to earlier intervention, potentially improving long-term outcomes and decreasing the overall burden of mental health issues in this population. This move also sets a precedent that other insurers may follow, broadening the accessibility of TMS therapy. The involvement of a medical director in the review process ensures that the treatment is administered appropriately, which could mitigate concerns about misuse or over-reliance on this relatively new therapy.

From a financial perspective, the updated coverage policy by Humana could bolster Neuronetics, Inc.'s market position and revenue streams. By being the first commercial payer to cover NeuroStar TMS therapy for adolescents, Humana has effectively expanded the potential customer base for Neuronetics. With Humana's policies covering approximately 600,000 commercial lives, the addressable market for NeuroStar TMS has notably increased. This may lead to a rise in demand for the company's products, positively influencing their financial performance. In the short term, this announcement is likely to generate investor interest and could result in a positive impact on the stock price. Long-term effects will depend on further adoption by other insurers and the continued clinical efficacy of TMS treatment for adolescents.

The swift policy change by Humana following the FDA clearance of NeuroStar TMS for adolescents highlights the growing recognition and acceptance of TMS therapy within the healthcare sector. This development may prompt other insurance companies to follow suit, significantly broadening the market for Neuronetics. The precedent set by Humana could also encourage healthcare providers to adopt NeuroStar TMS more widely, given the increased likelihood of reimbursement. For retail investors, understanding the competitive advantage that Neuronetics holds as the first and only TMS company with this specific clearance is crucial. This unique position in the market could translate into substantial growth opportunities, provided the company continues to demonstrate the efficacy and safety of its product. Investors should also watch for any competitive responses or new entries into the TMS market, as these could impact Neuronetics' market share and growth potential.

Policy change comes quickly after FDA clearance for NeuroStar TMS use in ages 15 and older

MALVERN, Pa., May 15, 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 today that Humana has become the first commercial payer to update its policy in response to the Company’s recent clearance from the U.S. Food and Drug Administration (FDA) for NeuroStar TMS (transcranial magnetic stimulation) as a first-line add-on for adolescents aged 15-21 with MDD (major depressive disorder).

Humana policies cover approximately 600,000 commercial lives in the United States. Prior to the recent policy update, Humana’s TMS coverage extended to individuals 18 years and older. The revision now addresses requests for TMS treatment for adolescents 15-17 years of age as requiring review by a medical director. The effective date for this change was April 25, 2024, only one month after the NeuroStar FDA clearance was announced on March 25, 2024.

“The FDA clearance for NeuroStar TMS is the most significant treatment advancement in years for the often-underserved adolescent patient population. Humana’s quick action to acknowledge NeuroStar’s availability for young people 15 and older underscores this urgent mental health need,” stated Keith J. Sullivan, President & CEO of Neuronetics, Inc. “We’re also gratified to see that our health policy strategy is contributing to positive policy changes for TMS coverage. Collectively, our efforts will benefit not only the young people affected by depression, but also their parents and families who are looking for a way to help them.”

Neuronetics is uniquely positioned to effect change, as the first and only TMS company with this clearance, and as 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.

Media Contact:
EvolveMKD
646.517.4220
NeuroStar@evolvemkd.com


i World Health Organization, Depression Fact Sheet. Accessed April 29, 2024. https://www.who.int/news-room/fact-sheets/detail/depression.


FAQ

What is NeuroStar TMS therapy?

NeuroStar TMS therapy is a transcranial magnetic stimulation treatment for neurohealth disorders, including major depressive disorder (MDD).

What is the new policy change regarding NeuroStar TMS coverage by Humana?

Humana has updated its policy to cover NeuroStar TMS therapy for adolescents aged 15-17 with MDD, following FDA clearance.

When did Humana's new TMS coverage policy take effect?

The new policy took effect on April 25, 2024.

How many lives are covered under Humana's updated TMS therapy policy?

Approximately 600,000 commercial lives are covered under the new policy.

When was the FDA clearance for NeuroStar TMS therapy for adolescents announced?

The FDA clearance was announced on March 25, 2024.

What age group does the NeuroStar TMS therapy FDA clearance for adolescents cover?

The FDA clearance covers adolescents aged 15-21.

What is required for TMS treatment requests for adolescents aged 15-17 under Humana's policy?

Requests for TMS treatment for adolescents aged 15-17 require review by a medical director under Humana's policy.

Neuronetics, Inc.

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