ZimVie’s Tether Receives Additional Insurance Coverage

ZimVie announced that Highmark, an independent licensee of the Blue Cross Blue Shield Association (which covers mainly Pennsylvania, New York, Delaware, and West Virginia) and BCBS North Dakota have issued positive medical policy decisions for vertebral body tethering (VBT).
 
The policies describe criteria for medical necessity and expand treatment eligibility to patients indicated for VBT within the over four million Highmark members and over 280,000 lives covered by BCBS North Dakota.
 
“The Highmark and BCBS North Dakota coverage decisions validate the expectation we noted when we announced the Anthem BCBS positive coverage decision in July, that additional policy updates would follow. It is encouraging to see broader endorsement of this opportunity to positively impact the lives of children with scoliosis through a motion preserving alternative to spinal fusion,” Rebecca Whitney, SVP and president of Global Spine for ZimVie, told the press. “We are honored to work with orthopedic and neurosurgeons to develop vertebral body tethering solutions that may allow children with scoliosis to return to their active daily lives.”
 
ZimVie’s Tether is a first of its kind non-fusion scoliosis treatment and the only FDA-approved device for VBT. According to the company, over 1,300 children have received The Tether since HDE (humanitarian device exemption) approval in August 2019.
 
About 65 U.S. surgeons perform the procedure today.
 
“Highmark’s recent positive policy decision for vertebral body tethering highlights the advancements that have come through diligent research in understanding the optimal patient indications for this promising technology,” said Amer Samdani, M.D., board-certified neurosurgeon, chief of surgery for Shriners Hospitals for Children – Philadelphia, and pioneer in vertebral body tethering. “As VBT relies on remaining growth potential, I am thrilled that this timely approval will allow an increased pediatric patient population to access treatment without missing the window of opportunity.”