A total of 99.8 million patients across the U.S. are now covered for MR-guided focused ultrasound (MRgFUS) procedures, thanks to a major health insurance company provider.

InSightec announced today that its Exablate for pain palliation of bone metastases falls into the insurance company’s coverage, though Insightec did not receive approval to announce which provider, Xen Mendelsohn Aderka, vice president of marketing at InSightec, told HCB News.

The Exablate treatment — which is FDA approved for patients who suffer from pain associated with bone metastases — uses focused ultrasound waves to destroy the targeted tissue while the physician uses real time MR-guided monitoring.
“This coverage decision is a huge win for our cancer patients suffering with bone pain,” said Dr. Sean M. Tutton, director at the division of interventional radiology and professor of radiology, palliative medicine, and surgery at the medical center of Wisconsin, in a statement.

“MRgFUS has proven to be an effective and totally noninvasive treatment in reducing pain and narcotic needs even in patients that have failed radiation already,” he said.

According to the announcement, up to 70 percent of bone metastases patients suffer from severe pain, and radiotherapy is unsuccessful in relieving pain for 30 to 40 percent of those patients.

In late December of 2015, InSightec announced that five additional licensees of Blue Cross Blue Shield (BCBS) — BCBS Louisiana, Florida Blue, Independence BCBS, Highmark BCBS and Blue Shield of California — are providing coverage for InSightec’s MRgFUS procedure.

“We are very happy that our work continues to yield favorable decisions, which will enable patients suffering from metastatic bone pain access to a noninvasive treatment that quickly reduces pain, allows return to normal activities within days, and is available in leading medical centers across the U.S.,” said Dee Kolanek, InSightec’s vice president of reimbursement, at that time.

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