BOSTON SCIENTIFIC STENT GAINS ADDED MEDICARE COVERAGE
Boston Scientific has been granted a new technology add-on payment (NTPA) for its Eluvia drug-eluting vascular stent system from the Centers for Medicare & Medicaid Services.
Under the Inpatient Prospective Payment System (IPPS), CMS pays for a patient’s inpatient hospital stay under one bundled payment, which covers all costs for acute care services performed. Some examples of costs include room and board, operating room, nursing, supplies, laboratory services, and radiology. Although drugs, devices, and supplies typically fall under this bundled payment, there is an exception to this rule, known as new technology add-on payments.
When certain criteria are met, CMS may provide additional payment for new, high-cost technologies in the inpatient setting. An NTAP provides additional payment to hospitals above the standard Medicare Severity Diagnosis-Related Group (MS-DRG) payment amount. A given technology’s NTAP designation lasts no more than three years for a specific indication.
Boston Scientific’s Eluvia drug-eluting vascular stent system received the NTAP as part of the 2021 IPPS. The NTAP became effective Oct. 1 to provide eligible hospitals with incremental reimbursement for Eluvia.
Jeff Mirviss, executive vice president and president of peripheral interventions at Boston Scientific, said Eluvia treats peripheral artery disease (PAD) by reopening the blocked artery and restoring blood flow while also utilizing a drug-polymer combination to offer a sustained, low-dose drug release to prevent tissue regrowth within the stented artery.
“The CMS determination is a very positive development for patients with PAD and supports what we have confirmed through our clinical trials – the Eluvia stent offers clinically superior outcomes compared to other peripheral drug-coated technology available to clinicians and their patients,” Mirviss said.
“The decision is particularly important given the level of consideration and evaluation related to the role of paclitaxel in the peripheral vasculature, and we believe this designation reflects the unique attributes of the Eluvia stent, which are clearly differentiated and improve the quality of life for the millions of people suffering from symptoms of PAD.” VTN