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Anthem incorporates MR-guided focused ultrasound for essential tremor into coverage

by John R. Fischer, Senior Reporter | December 28, 2022
Alzheimers/Neurology Insurance MRI Ultrasound
Anthem will cover MR-guided focused ultrasound treatment for essential tremor.
Access to MR-guided focused ultrasound for medication-refractory essential tremor will now become more affordable for many patients following Anthem’s decision to cover the treatment.

Essential tremor is a movement disorder characterized by uncontrollable shaking, commonly on both sides of the body. It affects an estimated ten million Americans. For those that do not respond to medications, focused ultrasound is an alternative.

The insurance provider is now the third national payor to cover this type of care, which is performed in a single, outpatient procedure and immediately improves hand tremors in many patients with minimal complications.
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Insightec, the developer of the Exablate Neuro platform for essential tremor, called the decision “game-changing” for its care objectives.

“We don’t just want to be a company that creates paradigm-shifting technology. We want to do whatever we can to give patients access to transformative procedures that give them back their ability to live independently, return to work, and improve their mental and physical health. We thank Anthem for helping us work to achieve that goal,” said Dr. Maurice Ferré, Insightec’s CEO and chairman of the company board of directors, in a statement.

Medicare covers focused ultrasound treatment for medication-refractory essential tremor in all 50 states.

The Blue Cross Blue Shield Association became the first national payor to cover the treatment in its plans, starting in August 2018. Aetna followed it in April 2021.

Insightec’s Exablate Neuro platform administers sound waves, safely guided by MR imaging, to treat the condition. Currently, more than 125 treatment centers worldwide use the solution.

The company also recently received additional FDA approval to treat patients on their second side at least nine months after treating them on the first for the condition.

The approval was based on an Insightec-sponsored study of 51 patients, who saw a highly significant reduction in tremors following treatment on the second side, with results immediate and sustained over at least six months of follow-up.

Treatment outcomes were consistent with those from treatment on the first side, and there was significant improvement in functional disability, indicating clinically meaningful impacts on daily living activities. The majority of adverse events were mild, and safety profiles were also similar to those for treatment on the first side.

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