Inspire Medical Systems Inc announced that Aetna Inc will provide coverage for the company’s Inspire therapy for obstructive sleep apnea, effective immediately. Aetna’s health plan provides coverage for approximately 22 million members.
“We are very pleased to receive this positive coverage decision from Aetna. We believe this coverage decision is a major milestone and has the potential to facilitate patient and physician access to and interest in Inspire therapy,” says Tim Herbert, president and CEO of Inspire Medical Systems, in a release. “There is a strong body of clinical data supporting Inspire therapy, including the 5-year STAR data, the ADHERE 300-patient registry data and other supportive publications. We believe our growing body of clinical and real-world data will be the basis for further coverage decisions by other major health plans.”
Under its policy, Aetna considers Inspire’s Food and Drug Administration (FDA) approved hypoglossal nerve neurostimulation device to be medically necessary for the treatment of moderate to severe OSA when a number of criteria are met. These include a previous attempt at continuous positive airway pressure (CPAP) treatment and patient selection consistent with FDA approval guidelines.