Wright Medical Group N.V. (NASDAQ: WMGI) today announced that the
Centers for Medicare & Medicaid Services (CMS) published an
update to the reimbursement calculation used to determine the
transitional pass-through payment for the device category
applicable to AUGMENT® Regenerative Solutions, including
AUGMENT® Bone Graft and AUGMENT® Injectable, originally implemented
on January 1, 2020. Based on this update, when hindfoot and
ankle fusions are performed in the hospital outpatient and
ambulatory surgical center settings of care, the facility will be
paid for the incremental cost of AUGMENT, thereby facilitating
Medicare beneficiary access to the advantages of AUGMENT by
removing an economic barrier.
This update is made retroactive to January 1, 2020, and the
existing transitional device pass-through code (C1734) may be used
to bill for AUGMENT for hindfoot and ankle fusion procedures when
used in treatment of Medicare beneficiaries enrolled in Medicare
Part B under the traditional Medicare program.
Robert Palmisano, president and chief executive officer of
Wright, commented, “The update to the transitional pass-through
payment in the outpatient setting will help ensure healthcare
providers have access to AUGMENT Regenerative Solutions, which
offer a clear patient benefit by eliminating the complications of
the additional surgery required to harvest autograft that can
result in site-specific complications and/or prolonged harvest site
pain in some patients. Wright has been dedicated to advancing
the standard of care for hindfoot and ankle fusion, and we are
proud that the Centers for Medicare & Medicaid Services, the
country's largest payer for health care, recognizes the importance
of our AUGMENT technology to its beneficiaries.”
Dr. Gregory C. Berlet of the Orthopedic Foot and Ankle Center in
Westerville, Ohio, stated, “This transitional pass-through payment
is monumental for my hindfoot and ankle arthritis patients who
require a fusion procedure. AUGMENT is already proven to
offer clear patient benefit by enabling a healing rate and safety
profile non-inferior to autogenous bone graft. Based upon the data
showing more consistent fusion outcomes in patients aged 65 and
older as compared to autograft, and the approval of the
transitional pass through payment, I can now use AUGMENT in
outpatient facilities for these patients as the economic concerns
have been resolved.”
Transitional pass-through payments are intended to facilitate
Medicare beneficiary access to the advantages of new and innovative
devices by allowing for adequate payment for these new devices
while the necessary cost data is collected to incorporate the costs
for these devices into the procedure
Ambulatory Payment Classifications rate. After rigorous
vetting, the CMS concluded that AUGMENT is of great clinical
utility in the outpatient setting and approved Wright’s application
for transitional pass-through payment, which became effective
January 1, 2020. This marked the first orthopedic implant to
secure pass-through payment approval in over a decade1, unlocking
access to benefits for patients, physicians and facilities,
including:
- AUGMENT improves patient outcomes by eliminating chronic pain
associated with the autograft harvest site, which was found to be
clinically significant at 52 weeks in 8.8% of patients and 5.2% of
patients at an average follow-up of 9 years.2,3
- AUGMENT was found to provide two times the odds ratio for
fusion success on CT compared to autograft in patients 65 years of
age or older.4
- AUGMENT eliminates medically significant surgical complications
associated with the autograft harvest from a second surgical site,
which were found to occur in 8.9% (15/167) of patients in the
AUGMENT clinical trials.2,5,6
For additional AUGMENT Regenerative Solutions reimbursement
support tools and information, visit
www.wright.com/Reimbursement.
Internet Posting of Information
Wright routinely posts information that may be important to
investors in the “Investor Relations” section of its website at
www.wright.com. The company encourages investors and
potential investors to consult the Wright website regularly for
important information about Wright.
About Wright Medical Group N.V.
Wright Medical Group N.V. is a global medical device company
focused on extremities and biologics products. The company is
committed to delivering innovative, value-added solutions improving
quality of life for patients worldwide and is a recognized leader
of surgical solutions for the upper extremity (shoulder, elbow,
wrist and hand), lower extremity (foot and ankle) and biologics
markets, three of the fastest growing segments in
orthopedics. For more information about Wright, visit
www.wright.com.
1. Search of www.cms.gov conducted 6/29/2020.2. DiGiovanni CW,
Lin SS, Baumhauer JF, et al. Recombinant human platelet-derived
growth factor-BB and beta-tricalcium phosphate
(rhPDGF-BB/β-TCP): an alternative to autogenous bone graft. J
Bone Joint Surg Am. 2013;95(13):1184-1192.3.
Baumhauer JF, Glazebrook M, Younger A, et al. Long-term Autograft
Harvest Site Pain After Ankle and Hindfoot
Arthrodesis [published online ahead of print, 2020 May
20]. Foot Ankle Int.
2020;1071100720920846.4. Berlet G, Baumhauer J, Glazebrook M, et
al. Impact of Patient Age and Graft Type on Fusion
Following Ankle and Hindfoot Arthrodesis. 2020
AAOS Annual Meeting.5. Daniels TR, Younger A, Penner MJ, et al.
Prospective Randomized Controlled Trial of Hindfoot and
Ankle Fusions Treated With rhPDGF-BB in
Combination With a β-TCP-Collagen Matrix. Foot Ankle
Int. 2015;36(7):739-748.6. Daniels TR, Anderson
J, Swords MP, et al. Recombinant Human Platelet-Derived Growth
Factor BB in Combination With a Beta-Tricalcium
Phosphate (rhPDGF-BB/β-TCP)-Collagen Matrix as an
Alternative to Autograft. Foot Ankle Int.
2019;40(9):1068-1078.
Cautionary Note Regarding Forward-Looking Statements
This release includes forward-looking statements under the
Private Securities Litigation Reform Act of 1995. These
forward-looking statements generally can be identified by words
such as “believe,” “expect,” “estimate,” “predict,” “target,”
“potential,” “likely,” “continue,” “ongoing,” “could,” “should,”
“intend,” “may,” “might,” “plan,” “seek,” “anticipate,” “project”
and similar expressions, as well as variations or negatives of
these words. Forward-looking statements in this release include,
without limitation, statements regarding the performance and market
acceptance of the Company’s products, the pricing of the Company’s
products, and the timing of and ability to obtain reimbursement of
procedures utilizing the Company’s products. Investors are
cautioned that any such forward-looking statements are not
guarantees of future performance and involve risks and
uncertainties and are cautioned not to place undue reliance on
these forward-looking statements. Actual results may differ
materially from those currently anticipated due to a number of
risks and uncertainties. Applicable risks and uncertainties
include, among others, physician acceptance, endorsement, and use
of Company products; the effect of regulatory actions, changes in
and adoption of reimbursement rates; product liability claims;
product recalls; the effects of industry, economic or political
conditions outside of the Company’s control; competitor activities;
and other risks and uncertainties detailed from time to time in
documents filed with the Securities and Exchange Commission (the
“SEC”) by the Company, including current reports on Form 8-K,
quarterly reports on Form 10-Q and annual reports on Form 10-K. All
forward-looking statements are based on information currently
available to the Company, and the Company assumes no obligation to
update any forward-looking statements.
Investors & Media:
Julie D.
Dewey
Sr. Vice President, Chief Communications
OfficerWright Medical Group N.V.(901)
290-5817julie.dewey@wright.com
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