*The number of insurance carriers covering cross-linking and the number of covered lives listed here have been updated as of April 5th 2019. To view the current list of insurance plans with positive coverage policies, go to the Insurance Information page.
Providence Health Plan, Health New England, HealthPartners Minnesota and Public Employees Health Plan Are Latest to Join Extensive List of Payers Covering Over 95% of Estimated Total U.S. Addressable Market for Progressive Keratoconus
Avedro, Inc., (Avedro or the company), today announced that four new providers –Providence Health Plan in the Pacific Northwest, Health New England, HealthPartners Minnesota and Public Employees Health Plan (PEHP) in Utah–have issued positive coverage policies for Avedro’s FDA-approved corneal cross-linking procedure, bringing the total number of commercial plans covering the KXL system and its associated Photrexa® drug formulations to over 65. These four plans bring the total number of covered lives in the United States to more than 180 million.
Keratoconus is a debilitating and typically progressive eye disease that can lead to loss of vision and even blindness. Avedro’s KXL system and associated Photrexa®drug formulations have been approved by the FDA as a one-time treatment that can slow or halt the progression of the disease, potentially eliminating the need for invasive procedures such as corneal transplant.
In addition, Avedro has secured positive coverage from the United States’ largest national commercial payers, including United Healthcare, Anthem Blue Cross Blue Shield, Aetna, Cigna, Humana, and HealthNet. The company estimates that more than 95% of commercially covered lives have access to the Avedro’s potentially sight-saving technology.
“We are very pleased to see that in just one year, access has rapidly and dramatically improved for patients needing therapeutic treatment for progressive keratoconus,” said Reza Zadno, Ph.D., Chief Executive Officer of Avedro. “In addition to securing coverage from our country’s top commercial payers, we’ve received a unique J-code from CMS. This is in large part due to the amazing support and hard work of the societies, doctors and patient advocacy groups who see and hear from patients daily. Avedro will continue to invest in reimbursement services to ensure corneal cross-linking is accessible to patients struggling with progressive keratoconus.”
Patients can find the list of private payer insurance companies providing coverage for corneal cross-linking on the Insurance Information page.