Dive Brief:
- UnitedHealthcare will provide coverage for Inspire Medical Systems' obstructive sleep apnea therapy beginning Aug. 1, the Minneapolis medtech announced Monday.
- The decision comes almost a year to the day after Aetna agreed to cover Inspire's hypoglossal nerve neurostimulation system. A number of BlueCross BlueShield plans have also stepped up to cover the Medtronic spinout's device within the past year.
- UnitedHealth's reimbursement commitment is restricted to selected patients who have already attempted continuous positive airway pressure (CPAP) therapy, among other criteria.
Dive Insight:
Around 20 million Americans likely suffer from obstructive sleep apnea, which disrupts breathing during sleep due to throat muscles relaxing and blocking the airway.
Unlike the CPAP masks offered by device makers like ResMed and Philips, Inspire's technology consists of a fully implanted stimulation lead, generator and breathing sensor lead that are meant to track breathing patterns and deliver targeted stimulation to the hypoglossal nerve, which in part controls tongue muscles, to help keep airways open during sleep. The system is operated via a handheld remote.
High rates of nonadherence with CPAP therapy have boosted the appeal of Inspire's pitch. The upper airway stimulation system gained its CE mark in 2010, FDA's premarket approval in 2014 and regulatory approval from Japan's Ministry of Health, Labour and Welfare in 2018. The company went public in May 2018.
The addition of UnitedHealth brings Inspire's total coverage policies to 35, or 125 million members, which the company said in its announcement compares to 3 million members one year ago.
Inspire expects 2019 revenues in the range of $69 million to $72 million, which would represent close to 40% growth compared to 2018. As of May, the company reported there being 226 total implanting centers in the U.S., with executives predicting the company will add 12 to 14 new centers each quarter in 2019.
Inspire's stock was up more than 4% Monday on the news.
