Cigna’s Coverage Policy includes procedures enabled with OMNI® Surgical System technology as medically necessary and covered.
Sight Sciences Inc. announced Cigna Healthcare has updated its Glaucoma Surgical Procedure policy to cover both ab interno canaloplasty and goniotomy (trabeculotomy) procedures for the treatment of open-angle glaucoma eﬀective June 15, 2023.
According to a company news release, Cigna is one of the largest health insurance companies in the United States with close to 15 million covered lives.
The OMNI Surgical System technology is FDA-cleared and indicated for canaloplasty followed by trabeculotomy to reduce intraocular pressure (“IOP”) in adult patients with primary open-angle glaucoma. OMNI technology enables the surgeon to perform an outflow restorative procedure to address the three known points of aqueous resistance associated with glaucoma (Schlemm’s canal, collector channels, and trabecular meshwork). The procedure can be performed before, in combination with, or after cataract surgery.
Paul Badawi, founder and CEO of Sight Sciences, said the company is pleased with Cigna’s clinical review resulted in expanded coverage of certain non-implant, minimally invasive glaucoma surgery (“MIGS”) procedures including canaloplasty and goniotomy for its patents.
“As a result of this positive coverage policy, Cigna’s members will have access to the OMNI outflow restorative procedure that addresses all three points of resistance when deemed medically necessary by their ophthalmologist,” he said. “We believe Cigna’s decision aﬃrms the shift towards safer, less invasive, but more comprehensive surgical inventions, and cements the role that OMNI’s technology serves within the glaucoma treatment paradigm for surgeons and patients.”
According to the news release, data evidencing the effectiveness and safety of OMNI have been published in 18 peer-reviewed publications, representing more than 630 patients to date, including two landmark multicenter studies, GEMINI and ROMEO.
The company also noted that real-world data leveraging the American Academy of Ophthalmology’s IRIS Registry was presented at the 2023 American Society of Cataract and Refractive Surgery and the American Glaucoma Society Annual Meetings, where a 12-month sub-analysis of patients treated with OMNI Surgical System technology reported the greatest average reduction in IOP-lowering medication usage compared to implant-based MIGS procedures or cataract surgery alone.
“We are pleased that Cigna has expanded coverage and increased patient access to more minimally invasive glaucoma surgeries,” Elena Sturman, president and CEO of The Glaucoma Foundation, one of the nation’s leading foundations, said in a statement.
“Glaucoma is the leading cause of irreversible blindness in the United States. Improving access to less invasive outflow restorative procedures (associated with OMNI technology) is an important addition for glaucoma patients,” she concluded.
Cigna Healthcare’s updated Glaucoma Surgical Procedures policy can be found online.