ABBOTT PARK, Ill., February 3, 2022 — Abbott today announced that UnitedHealthcare (UHC), the largest private health insurance company in the United States, has updated its ‘Implanted Electrical Stimulator for Spinal Cord’ medical policy to expand patient access to Abbott’s dorsal root ganglion (DRG) neurostimulation devices for people suffering from chronic pain when medical policy criteria are met. This updated medical policy covers 26 million UHC commercial members and will go into effect on March 1, 2022.
UnitedHealthcare’s new coverage assessment provides access to Abbott’s non-opioid DRG stimulation, the world’s only neurostimulator specifically designed to treat complex nerve pain conditions caused by complex regional pain syndrome (CRPS) or peripheral causalgia, which are forms of chronic pain that that affect the lower extremities up to the hips, including the pelvis, after an injury or surgery. An estimated 50 million Americans suffer from chronic pain for whom DRG stimulation represents an important new treatment option.iii
"The addition of coverage for a DRG stimulation therapy by one of the nation’s largest insurers is an important development for patients living with chronic pain who have exhausted other treatments," said Kiran Patel, M.D., Spine and Pain Institute of New York. "The new clinical guidance from UnitedHealthcare means that people will now have the ability to consider Abbott’s DRG treatment as an accessible option to manage their chronic pain."
CRPS and causalgia usually follow trauma, amputation, or surgery, such as hernia repair, knee or hip replacement, and result in chronic burning or stinging pain, numbness, hypersensitivity to touch, and chronic persistent pain in the lower limbs. These conditions have historically been challenging to treat because of the disruption in how the nervous system processes or transmits pain signals often resulting in long-lasting disabling chronic pain.
For patients suffering from CRPS or causalgia, DRG neurostimulation has been found to provide greater pain relief when compared to traditional spinal cord stimulation.iv
DRG therapy works by stimulating the dorsal root ganglia (DRG), a bundle of nerves located on the outside of the spinal cord. These nerve structures along the spinal column are made up of densely populated sensory nerves, and act like traffic lights, regulating signals and sensations that travel through nerve fibers along the spinal column to the brain. DRG stimulation therapy involves implanting a small battery device, typically in the abdomen or buttock,i and running thin insulated wires, called leads, near the DRG. The leads deliver electrical pulses to the nerves, which block pain signals from traveling to the spinal cord and the brain thereby reducing pain in specific locations in the body.
"Neuropathic pain is one of the most prevalent and under-treated forms of chronic pain," said Pedro Malha, vice president of Abbott’s neuromodulation business. "The new coverage guidance by UnitedHealthcare to offer these patients DRG stimulation is yet another step forward in providing people with a safe and effective treatment alternative for their chronic pain. We are working with a number of other commercial payors to continue to extend the benefits of DRG stimulation therapy so as many people as possible can benefit."
Abbott’s Proclaim™ dorsal root ganglion (DRG) neurostimulation system is the only FDA-approved DRG technology for the treatment of CRPS I and causalgia of the lower extremities.i The system is low maintenance and recharge free, meaning patients do not need to pause from their daily activities to charge their battery as with other systems. Using Bluetooth® wireless connectivity, patients can feel empowered by controlling their prescribed stimulation levels through a familiar Apple iPod touch® device or app on their iPhone. It is also compatible with Abbott's NeuroSphere™ Virtual Clinic, a first-of-its-kind technology that allows patients to communicate with physicians and receive new treatment settings remotely without having to travel to their physician’s office. Patients are able to try DRG stimulation with a weeklong therapy trial, or temporary evaluation, before receiving a permanent implant.
About Abbott's Chronic Pain Portfolio
Chronic pain can negatively impact personal relationships, work productivity and a person's daily routine. Abbott is a global leader in the development of chronic pain therapy solutions, offering radiofrequency therapy and spinal cord stimulation therapy solutions, including radiofrequency ablation generators and accessories, BurstDR™ stimulation, and dorsal root ganglion stimulation in the portfolio of chronic pain treatments.
Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 113,000 colleagues serve people in more than 160 countries.
i Abbott. Proclaim™ DRG Neurostimulation System Clinician’s Manual. Plano, TX. 2018.
ii United Health Group 3Q 2021 Form 10-Q earnings release: https://www.unitedhealthgroup.com/viewer.html?file=/content/dam/UHG/PDF/investors/2021/UNH-Q3-2021-Form-10-Q.pdf
iii Dahlhamer J, Lucas J, Zelaya, C, et al. Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016. MMWR Morb Mortal Wkly Rep 2018;67:1001–1006. DOI: http://dx.doi.org/10.15585/mmwr.mm6736a2external icon.
iv Deer, TR, Levy, RM, Kramer, J, et al. (2017). Dorsal root ganglion stimulation yielded higher treatment success rate for complex regional pain syndrome and causalgia at 3 and 12 months: a randomized comparative trial. Pain. 158(4): 669-681. http://dx.doi.org/10.1097/j.pain.0000000000000814 ACCURATE IDE STUDY, St. Jude Medical.