Obsessive Compulsive Disorder (OCD) has been ranked by World Health Organization as one of the top 10 most debilitating medical conditions in terms of loss of income and reduced quality of life. The condition is complex, presenting differently in each patient, many of which are drug-resistant. These challenges make treating OCD difficult. Many patients suffering from this condition do not respond well to traditional treatment options such as cognitive behavioral therapy and medication.
Brainswayan Israeli company that provides non-invasive neurostimulation treatments for mental disorders is working to solve this problem by deeply transcranial magnetic stimulation (TMS) device. In Thursday, Cygna declared it to be so revision its TMS medical coverage policy to extend coverage for the Brainsway deep TMS device to patients age 18 and older who have been diagnosed with OCD.
With its policy change, Cigna now joins several other major insurers that cover the device, including Centene, Highmark, Blue Cross Blue Shield, Tricare and Palmetto GBA. More than 86 million adults now have access to BrainsWay’s deep TMS treatment for OCD, said CEO Christopher von Jako.
TMS is a non-invasive treatment that activates brain structures through directed electromagnetic fields that generate the excitation of neurons. Brainsway specializes in deep TMS treatment, an advancement of traditional TMS. Deep TMS uses flexible H-coils embedded in a patient- and operator-friendly helmet. These non-invasive activate targeted brain structures that can address a range of mental conditions.
The H-Coil design in Brainway’s device allows for deeper and wider stimulation than traditional TMS coils, according to von Jako. This results in greater neuronal activation and less likelihood of targeting errors.
There are companies that provide traditional TMS solutions – such as neuronetics and MagVenturewhich also have devices approved to treat OCD in the US. But von Jako claims that Brainsway is the only company that offers a deep TMS.
Patients who use Brainway’s deep TMS device to treat OCD use it daily for 3 to 20 minutes. They use it for at least four weeks, with the option of later integrating it into their daily schedule, according to von Jako. Since its introduction in 2019, the response rate for Brainsway’s device in real-world clinical practice has been close to 60%, with an average durability of about 2 years, he shared.
Under Cigna’s updated coverage policy, an initial deep TMS treatment regimen will be classified as medically necessary if the patient meets the following two criteria: two or more failed drug trials and a trial of evidence-based psychotherapy without significant improvement in symptoms. This treatment regimen includes 30-36 sessions.
The policy also provides that patients who experience a 30% or greater improvement in their results on Yale-Brown Obsessive-Compulsive Scale — the most common OCD rating scale — maintained for at least two months are candidates for an additional regimen of 30-36 more sessions.
Cigna is one of the largest health plans in the US — it provides commercial health coverage to about 17 million members in 13 states and has Medicare Advantage plans in 16 states. Cigna also participates in the online Health Insurance Marketplace. Getting a positive coverage policy is a huge step for Brainsway, von Jako said.
“If I was talking to you about a year ago, I would have told you that we don’t have coverage for deep TMS treatment for OCD patients,” he said. “With Cigna’s positive coverage policy, we have increased coverage to more than 85 million lives in the US. We have much more work to do and plan to continue to pave the way for even more positive coverage to increase patient access to this life-saving treatment.”
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