Experimental Or Established? Clinicians, Insurers Debate S-ICDs

Despite many electrophysiologists' enthusiasm for less-invasive cardiac rhythm management devices, insurers are frequently denying coverage of Boston Scientific's Emblem subcutaneous implantable cardioverter defibrillator (S-ICD) for patients, citing what they argue is a lack of adequate clinical data that shows them to be better than "experimental." Boston Scientific recently sponsored a virtual roundtable of physicians to discuss how new professional society guidelines are influencing prescribing and reimbursement of these devices.

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Boston Scientific's Emblem S-ICD in an anatomical illustration. • Source: Boston Scientific

Boston Scientific Corp.'s Emblem subcutaneous implantable cardioverter defibrillator (S-ICD) earned FDA approval in 2013. In 2017 professional society guidelines were issued on the management of ventricular arrhythmias and the prevention of sudden cardiac death that recommend S-ICDs for some patients. However, many payers still consider it an "experimental" therapy for the purposes of coverage.

Boston Scientific added the S-ICD technology to its portfolio when it acquired Cameron Health in 2012. (Also see "Exec Chat: From Cameron To Boston Scientific, Navigating Through CRM Challenges"...

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