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RED HOT Contributors


Inspire Medical scores reimbursement win from UnitedHealth


Inspire Medical SystemsInspire Medical Systems (NYSE:INSP) logged another reimbursement win, this time with the nation’s largest private insurer, UnitedHealth.

Minneapolis-based Inspire makes an eponymous device designed to treat obstructive sleep apnea using hypoglossal nerve stimulation. UnitedHealth has about 41 million lives under coverage, Inspire said.

“We are very pleased to receive this positive coverage decision from UnitedHealthcare. As health plans continue to update their coverage policies to include Inspire therapy, an increasing number of patients and physicians will have access to our innovative therapy,” president & CEO Tim Herbert said in prepared remarks. “With the addition of UnitedHealthcare, we now have 35 coverage policies, representing approximately 125 million members, that cover Inspire therapy compared to 3 million members one year ago.”

The UnitedHealth policy for Inspire covers patients whose previous continuous positive airway pressure therapy failed for their moderate to severe OSA.

Under its policy, UnitedHealthcare considers Inspire’s U.S. Food and Drug Administration (FDA) approved hypoglossal nerve neurostimulation device to be medically necessary for the treatment of moderate to severe OSA when specified criteria are met, including a previous attempt at  (CPAP) treatment as well as patient selection consistent with the FDA’s approval guidelines.

INSP shares got a bounce on the news, rising 5.9% to $67.65 apiece today in mid-day trading.

Early this year Inspire landed positive coverage decisions with a pair of Blue Cross Blue Shield affiliates.


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