Cigna subsidiary Evernorth Health Services is expanding its coverage of NeuroStar Transcranial Magnetic Stimulation (TMS) to include adolescents aged 15 and older living with major depressive disorder, in a bid to improve access to non-drug treatment options.
NeuroStar is an offering of Neuronetics, a vertically integrated medical technology and healthcare company focused on neurohealth therapies.
The expansion is effective immediately, nearly one year after NeuroStar Advanced Therapy received FDA clearance as the first first-line add-on treatment for adolescents aged 15-21 with MDD.
WHAT'S THE IMPACT
A 2023 World Health Organization study showed that an estimated 4.3 million U.S. adolescents aged 15-21 are affected by major depression. Depression amongst adolescents can disrupt crucial aspects of development, such as academic performance, relationships with peers and family members, and overall emotional well-being.
With limited medication options for adolescents with MDD, NeuroStar is billing itself as a safe and effective option that can be used as a first-line add-on.
The company added it has a dedicated health policy team that partners with providers and payers to advocate for health policy updates.
"This decision by Cigna/Evernorth is a significant step forward for adolescent mental healthcare and reflects the momentum we have built with payers over the past year since NeuroStar first received the FDA clearance for adolescents," said Neuronetics President and CEO Keith J. Sullivan.
THE LARGER TREND
The COVID-19 pandemic was particularly difficult for adolescent mental health. Emergency department utilization spiked in 2020 due in large part to suspected suicide attempts by people ages 12-17, many of them girls, according to the Center for Disease Control and Prevention.
During 2020, the proportion of mental health-related ED visits among adolescents in that age group increased 31% compared with 2019.
A 2024 Deloitte analysis projected mental health inequities could total about $478 billion in avoidable costs. Left unchecked, the numbers suggest this could balloon up to $1.3 trillion by 2040. That's equivalent to about $42,000 per person living in the U.S.
The other major mental health-related factor ramping up expenses is productivity loss, which is projected to account for about $116 billion in avoidable costs in 2024.
A 2023 KFF study found the ongoing mental health crisis in the U.S. is also disproportionately straining Medicaid, in part because behavioral health services cost the federal program more than they did other payers.
ON THE RECORD
"NeuroStar stands as the leading TMS device, backed by the most comprehensive data that clearly demonstrates its effectiveness in treating adolescent major depressive disorder," said Dr. Geoffrey Grammer, chief medical officer of Neuronetics.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.