Anthem Blue Cross and Blue Shield Adds Coverage for Severe Emphysema Treatment
Minimally Invasive Spiration® Valve System Now Available to Blue Cross Blue Shield Members in 14 States
The Spiration® Valve System has been demonstrated to improve quality of life for patients suffering from severe emphysema, a form of COPD (Chronic Obstructive Pulmonary Disease).i,iv,v Aetna, Humana, Highmark BCBS, HCSC, Blue Cross NC and now Anthem provide coverage for eligible patients to receive minimally invasive bronchoscopic lung volume reduction (BLVR) treatment using systems like the Spiration Valve.
CENTER VALLEY, Pa., (September 30, 2021) – Olympus today announced that Anthem Blue Cross Blue Shield, the second largest commercial health plan in the country, has updated their coverage policy to include the Spiration Valve System for patients suffering from severe emphysema, a form of COPD (Chronic Obstructive Pulmonary Disease). This follows positive coverage decisions by other BCBS plans, extending coverage for endobronchial valve therapy in the U.S.
The Spiration Valve System provides a minimally invasive treatment that has been shown to improve lung function and reduce breathlessness for eligible patients who are suffering from the debilitating symptoms of severe emphysema.i
Anthem is the largest independent licensee of the Blue Cross and Blue Shield Association, covering more than 33 million lives through their commercial and governmental plan types.ii The new commercial policy covers beneficiaries across 14 states: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, New Hampshire, Nevada, New York, Ohio, Virginia and Wisconsin.iii This positive coverage decision adds to a growing list of insurance companies that now cover endobronchial valve treatment, including Blue Cross and Blue Shield Association licensees Highmark and Health Care Service Corporation, Blue Cross Blue Shield North Carolina, Massachusetts, Michigan and North Dakota, Aetna, and Humana.
“This decision by Anthem will provide expanded access to a critical new therapy for patients suffering the breathlessness that comes with severe emphysema,” said Lynn Ray, Vice President and General Manager of the Global Respiratory Business Unit for Olympus Corporation. “Olympus is very proud of its role in developing minimally invasive treatment options that provide an alternative to open surgery, which can further compromise patients who are already vulnerable with a chronic condition like emphysema.”
“Clinical trials have proven that bronchoscopic lung volume reduction (BLVR) with endobronchial valves demonstrates statistically significant and clinically meaningful improvements in lung function, reduction in shortness of breath and improvement in quality of life compared to standard of care medical management,” said Dr. Grant Pierson, Pulmonologist with Freeman Health System in Joplin, MO.iv,v
For information about the Spiration Valve System, visit these dedicated websites:
- For patients and their families: https://svs.olympusamerica.com/patients-and-family
- For doctors: https://svs.olympusamerica.com/healthcare-professionals
- Full prescriptive information: https://svs.olympusamerica.com/prescriptive-information
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Olympus is passionate about the solutions it creates for the medical, life sciences, and industrial equipment industries.
Olympus' Medical business uses innovative capabilities in medical technology, therapeutic intervention, and precision manufacturing to help healthcare professionals deliver diagnostic, therapeutic, and minimally invasive procedures to improve clinical outcomes, reduce overall costs, and enhance the quality of life for patients. Olympus' Medical portfolio includes endoscopes, laparoscopes, and video imaging systems, as well as surgical energy devices, system integration solutions, medical services, and a wide range of EndoTherapy instruments. For more information, visit https://medical.olympusamerica.com.
- Prescriptive Information. svs.olympusamerica.com. https://svs.olympusamerica.com/prescriptive-information. Published March 2019. Accessed September 14, 2021.
- Data Sourced by Policy Reporter, a TrialCard Company. Accessed August 31, 2021.
- Stats & Facts. Antheminc.com. https://www.antheminc.com/NewsMedia/FrequentlyRequestedMaterials/StatsFacts/index.htm. Published 2020. Accessed September 22, 2021.
- Criner GJ, Delage A, Voelker K, et al. "Improving lung function in severe heterogenous emphysema with the Spiration® Valve System (EMPROVE): a multicenter, open-label, randomized, controlled trial." American Journal of Respiratory and Critical Care Medicine. 2019;200(11):1354-1362, 2019
- Wang G, Li S, Wang C, et. al. The REACH study, a randomized controlled trial assessing the safety and effectiveness of the Spiration Valve System endobronchial therapy for severe emphysema: 12 month follow-up results. European Respiratory Journal. 2017; 50(61); DOI: 10.1183/1393003.congress-2017.OA1465