Ohio's largest health insurer recognizes ingestible "capsule endoscopy" as primary evaluation tool
July 14, 2008 -- Capsule endoscopy company Given Imaging Ltd. (Yoqneam, Israel), said today that Medical Mutual of Ohio, the state's largest health insurer, now allows physicians to use Given's PillCam ingestible video cameras for primary tests (without prior use of other procedures) for patients suspected of small bowel tumors, Crohn's disease, and esophageal varices. "We anticipate additional coverage decisions like this in the future," said Given Imaging president and CEO Homi Shamir.
July 14, 2008 -- Capsule endoscopy company Given Imaging Ltd. (Yoqneam, Israel) (NASDAQ: GIVN, TELAVIV: GIVN), said today that Medical Mutual of Ohio, the state's oldest and largest health insurer, has updated its capsule endoscopy policy. Medical Mutual now allows physicians to use PillCam SB as a primary test (without prior use of standard endoscopic procedures and/or small bowel follow through -- SBFT) for symptoms indicative of small bowel tumors or Crohn's disease. Also, Medical Mutual will now allow the use of PillCam ESO in the evaluation of esophageal varices in patients who have esophageal varices or portal hypertension and when esophagogastroduodenoscopy (EGD) is contraindicated. Further, Medical Mutual's now allows the use of the Agile patency capsule -- used to verify adequate patency of the gastrointestinal tract in patients with known or suspected strictures -- prior to the administration of the PillCam video capsule.
Previously, PillCam capsule endoscopy of the small bowel under the Medical Mutual of Ohio policy could be used only after a negative upper and/or lower endoscopy to diagnose disorders such as Crohn's disease, celiac disease, benign and cancerous tumors, ulcerative colitis as well as other disorders.
"We anticipate additional coverage decisions like this in the future," said Given Imaging president and CEO Homi Shamir. "Today, more than 210 million Americans have reimbursed access to PillCam SB including 34 million Americans with access as a primary diagnostic tool. In addition, approximately 35 million Americans have reimbursed access to PillCam ESO."
Physicians can get details on the updated policy, which is already in effect, from Given Imaging's Reimbursement Help Line at 1-888-389-5200. Medical Mutual serves more than 3.9 million individuals in Ohio and South Carolina.
Given Imaging hopes to redefine gastrointestinal diagnosis by developing, producing and marketing innovative, patient-friendly products for detecting gastrointestinal disorders. Early last year, the company launched a consortium to help develop its PillCam platform, which features disposable, miniature video cameras contained in capsules that are ingested by the patient. PillCam SB video capsule enables visualization of the entire small intestine; the PillCam ESO visualizes the esophagus; the Agile patency capsule determines the free passage of the PillCam capsule in the GI tract; and the PillCam COLON visualizes the colon (the latter has received a CE Mark, but is not cleared for marketing or available for commercial distribution in the USA).