SI-BONE, Inc. Announces Exclusive, Positive iFuse Coverage decision by Medica35 U.S. payers now cover iFuse exclusively
SANTA CLARA, Calif., Aug. 25, 2020 (GLOBE NEWSWIRE) -- SI-BONE, Inc., (Nasdaq: SIBN), a Silicon Valley-based medical device company dedicated to solving musculoskeletal disorders of the sacropelvic anatomy, announced today that Medica published an exclusive, positive iFuse coverage policy effective August 19, 2020. Under the revised coverage policy, minimally invasive SI joint fusion is now covered for the treatment of moderate-to-severe SI joint pain exclusively when the iFuse Implant System® is used. Minimally invasive SI joint fusion will remain investigative for all other devices and procedures, and for all other indications.
“Medica’s decision to extend coverage for its members to minimally invasive SI joint fusion procedures exclusively using iFuse was supported by more than 80 peer-reviewed articles reviewing iFuse patient outcomes, including both prospective randomized trials and many independent studies,” said Jeffrey Zigler, Vice President of Market Access and Reimbursement at SI-BONE. “With the addition of Medica, there are now thirty-five U.S. commercial payers that cover SI joint fusion procedures only when iFuse is used.”
Medica is one of the three largest commercial payers in the state of Minnesota, with an estimated 1.1 million covered lives. Medica also has enrollees in health plans it operates throughout North Dakota, South Dakota, Wisconsin and Kansas.
SI-BONE is a medical device company that pioneered minimally invasive surgery of the SI joint with the iFuse Implant System. Studies have shown that the SI joint can be a source of pain in 15% to 30% of chronic low back pain. The iFuse Implant™, commercially available since 2009, is the only SI joint fusion device supported by multiple prospective clinical studies, including two randomized controlled trials, showing improved pain, patient function and quality of life resulting from treatment. There are over 80 peer-reviewed publications demonstrating the safety, durable effectiveness, and biomechanical and economic benefits unique to the iFuse Implant (www.si-bone.com/results). This body of evidence has enabled multiple government and private insurance payors to establish coverage of the SI joint fusion procedure exclusively when performed with the iFuse Implant System.
The iFuse Implant System is intended for sacroiliac fusion for conditions including sacroiliac joint dysfunction that is a direct result of sacroiliac joint disruption and degenerative sacroiliitis. This includes conditions whose symptoms began during pregnancy or in the peripartum period and have persisted postpartum for more than 6 months. The iFuse Implant System is also intended for sacroiliac fusion to augment stabilization and immobilization of the sacroiliac joint in skeletally mature patients undergoing sacropelvic fixation as part of a lumbar or thoracolumbar fusion. In addition, the iFuse Implant System is intended for sacroiliac fusion in acute, non-acute, and non-traumatic fractures involving the sacroiliac joint. There are potential risks associated with the iFuse Implant System. It may not be appropriate for all patients and all patients may not benefit.
SI-BONE and iFuse Implant System are registered trademarks of SI-BONE, Inc. ©2020 SI-BONE, Inc. All Rights Reserved. 10819-08252020