Following the Centers for Medicare and Medicaid Services’ (CMS) decision to make Alair® Bronchial Thermoplasty (BT) System eligible for Medicare reimbursement, Boston Scientific Corp, Natick, Mass, reports that two private payers have agreed to cover for the procedure for all their members. Minnesota-based HealthPartners and Michigan-based Priority Health recently issued the first public postings of positive insurance coverage policies providing their respective memberships with reimbursement for this procedure used to treat severe asthma.

While many private insurers have approved BT on a case-by-case basis, the coverage policies from Priority Health and HealthPartners are the first to include their full memberships, totaling about 2 million people.

CMS made the Alair catheter eligible for Medicare reimbursement through a separate “pass-through” payment when the procedure is performed in an outpatient hospital setting.

"The recent private payer coverage decisions for bronchial thermoplasty represent positive developments for severe asthmatics and the pulmonary physician community, and should lead to more widespread coverage for this innovative procedure," said David Pierce, president of the endoscopy division at Boston Scientific. "These coverage policies support the CMS payment decisions announced earlier this year and further confirm bronchial thermoplasty as a promising new advancement in the treatment of severe asthma."

Using the Alair System, BT uses thermal energy to reduce the airway smooth muscle associated with airway constriction in asthma patients. The results of the AIR2 Trial, published in a 2010 issue of the American Journal of Respiratory and Critical Care Medicine, found that in the year following BT, severe asthma patients treated with the Alair System experienced 32% reduction in severe asthma attacks; 84% reduction in emergency room visits for respiratory symptoms; 66% reduction in days lost from work/school or other activities due to asthma; and significant improvement in asthma-related quality of life.

Data supporting the persistence of these beneficial effects of BT out to at least 2 years following treatment were published in a 2011 issue of the Annals of Allergy, Asthma and Immunology.

The Alair System is a catheter-based device used in BT procedures to treat severe persistent asthma in patients 18 years and older whose asthma is not well controlled with medications. The product is approved by the US Food and Drug Administration and has been available in the United States since mid-2010.

Source: Boston Scientific Corporation