Last week Torax Medical, a privately-owned medical device company that develops and markets products designed to treat sphincter disorders, rocked the Gastroenterology world with a huge announcement. Effective on the 1st of April 2016, Health Care Service Corporation—the fourth largest commercial health insurer in the United States—instituted a medical coverage policy for the Linx Reflux Management System. It’s a huge win for the world of GERD, where physicians and patients have spent years battling for the Linx surgery to be covered by insurances.
Linx Reflux Management System, more commonly referred to as “Linx”, is a string of titanium-wrapped magnets that rings the lower esophagus to keep down food, bile, and stomach acid. The magnetic attraction between the beads helps maintain the sphincter’s barrier function and prevents reflux. The FDA unanimously approved the device, which is implanted using minimally invasive laparoscopic surgery, in 2012.
Insurance coverage has been a huge point of contention in the reflux world for a while now. The Linx surgery is currently covered under Medicare, but even though it’s been four years since Linx entered the market, most commercial insurance companies still refuse to grant coverage for the procedure. It’s a huge source of frustration for both patients and physicians, especially since many more invasive anti-reflux surgeries are covered by the majority of insurances.
Commercial insurance companies initially complained that, despite its unanimous approval from the FDA, they still considered the Linx device “investigational” and “too new to cover”. They wanted more time to study how the device performed in comparison to already existing anti-reflux alternatives like the Nissen fundoplication surgery, a procedure where a reflux barrier is created by wrapping a portion of the patient’s stomach around the lower portion of the esophagus.
After four years of overwhelming evidence legitimizing Linx as an effective, cost-efficient, minimally invasive solution for severe cases of chronic GERD, it looks like the commercial insurance industry is finally coming around. Health Care Service Corporation is a massive insurer, and this new policy will bring coverage of the Linx procedure to over 15 million patients through their affiliate organizations (BCBS of Illinois, BCBS of Montana, BCBS of Oklahoma, and BCBS of Texas).
There’s still a lot of work to be done before Linx is granted the coverage it deserves across the board by commercial insurance companies, but this is a massive step in the right direction. We can only hope that more and more companies see the value Linx offers to patients suffering from chronic GERD, and that slowly but surely we continue to work towards the day when medically necessary procedures like Linx are covered for every patient.
If you’ve been diagnosed with GERD and continue to have symptoms despite the medical and lifestyle treatments you’ve undergone, Linx might be the answer to your problems. You can learn more about the details of the procedure here, or schedule a time to consult with some of the best Linx surgeons in the US.