ZimVie Inc. (NASDAQ:ZIMV), a global life sciences leader in the dental and spine markets, today announced that Anthem Blue Cross Blue Shield (BCBS), a subsidiary/operating company of Elevance Health, has issued a positive medical policy decision applicable to anterior vertebral body tethering (AVBT), effective July 6, 2022. The decision expands potential treatment eligibility to patients indicated for AVBT within the 30+ million members covered under Anthem BCBS, and outlines the medical necessity criteria that must be met for coverage of AVBT.
“This decision marks a significant win for Anthem BCBS patients and the broader pediatric scoliosis community,” said Rebecca Whitney, SVP and President of ZimVie Spine. “Before the development of anterior vertebral body tethering, the primary surgical option for children with scoliosis was a spinal fusion with rigid rods that could limit mobility. The coverage decision from Anthem will provide children with greater access to AVBT as a motion preserving alternative that may allow them to return to their active daily lives. We hope that this decision also paves the way for policy updates from additional payers to positively impact the lives of children with scoliosis.”
ZimVie’s Tether™ device, a first-of-its-kind non-fusion scoliosis treatment, is the first and only FDA-approved device for AVBT. Its humanitarian device exemption (HDE) was granted based on over seven years of clinical data validating the safety and effectiveness of The Tether in scoliosis correction. Over 1,200 children have received The Tether since HDE approval in August of 2019, with approximately 50 U.S. surgeons performing the procedure today.
“This policy change is a victory for families with scoliosis who need surgery, have researched their options, and have chosen a surgery that has the potential to maintain motion and decrease future complications,” said Jaren Riley, M.D., a board-certified, fellowship-trained pediatric orthopedic surgeon and the first in the Rocky Mountain Region to perform vertebral body tethering. “I am also grateful to Anthem BCBS for taking the time to meet with me personally and examine the promising data I presented.”
