Insurers are increasingly scrutinizing spinal fusion procedures and putting up new hurdles that could curtail growth in the category.
Sales of Medtronic Inc. (NYSE:MDT) spinal products plateaued between 2009 and 2010 after years of increases.
The number of spinal fusion procedures performed in Minnesota fell off slightly in 2009 after a decade of growth, according to The St. Paul Pioneer Press.
Meanwhile, health insurers and an increasing number of doctors think too many patients are getting lumbar fusions without first exhausting less expensive non-surgical options such as exercise, physical therapy and epidural steroid injections.
Blue Cross Blue Shield of North Carolina issued new rules last month that require surgeons to get prior review and approval from the insurance company before they will cover the procedures. Bloomington, Minn.-based HealthPartners started requiring patients to review booklets or videos about treatment alternatives before allowing the procedure.
Medtronic is responding by ramping up its marketing efforts, hoping to create new clinical and economic evidence to support the products.
