Highmark, the USA’s fourth-largest Blue Cross and Blue Shield-affiliated insurer, has expanded positive coverage of sacroiliac joint fusion devices. All devices cleared by the US Food and Drug Administration (FDA) for this indication, including cages or screws, with or without cages, are to be covered by the insurer from 21st August 2017.
In August 2017, SI-Bone announced that the insurer was to exclusively cover the Ifuse device for minimally invasive sacroiliac joint fusion. Now, Zyga—manufacturers of the rival SImmetry sacroiliac joint fusion device—have announced the Highmark news.
“We are pleased with Highmark’s recent decision to expand their instrumentation coverage for minimally invasive sacroiliac joint fusion,” commented Jim Bullock, president and chief executive officer of Zyga Technology. “This change will allow treatment decision making to be at the surgeon and patient level where it belongs.”
The Centers for Disease Control and Prevention lists low back pain as the second most common cause of disability in US adults. It has been reported that approximately 20% of all chronic LBP derives from the sacroiliac joint.
Highmark will cover Zyga’s SImmetry and other systems
Zyga recently received a US patent for the SImmetry technology, which decorticates the bone in preparation for sacroiliac joint fusion. Twenty-four month results from a study of the device in 18 patients revealed positive fusion results earlier this year. Ninety-four per cent of patients demonstrated bridging bone across the joint, with 79% displaying solid fusion radiographically. The 100th patient was enrolled in the company’s Evolusion multicentre clinical study of the system in April of this year. This prospective, 40-site, 250-patient trial will evaluate long-term fusion and pain reduction in patients receiving SImmetry sacroiliac joint fusion.