Health Care Service Corporation Now Covering Zephyr Valve in US

Marisa Wexler MS avatar

by Marisa Wexler MS |

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Zephyr Valve coverage

Health Care Service Corporation (HCSC) has issued a positive coverage policy for Pulmonx’s Zephyr Endobronchial Valve for treating severe emphysema, a form of chronic obstructive pulmonary disease (COPD).

HCSC is the largest customer-owned health insurer in the U.S., and the fifth largest insurer overall. HCSC operates Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas, providing coverage to more than 16 million people.

The new policy was effective Sunday (Nov. 1). Other major insurers that also cover the Zephyr Valve include Priority Health, Humana and Aetna.

“We commend HCSC for making this positive coverage decision, providing its members with severe emphysema access to a minimally invasive option to breathe easier and have a better quality of life,” Glen French, president and CEO of Pulmonx, said in a press release.

“As a pulmonologist in Illinois I am very excited to see the Zephyr Valve covered by these Blue Cross Blue Shield plans,” said D. Kyle Hogarth, MD, professor of medicine and director of bronchoscopy at the University of Chicago.

“Despite taking the best available medications, many COPD patients struggle to breathe and until the valves became available, the other options were invasive surgeries with high risks,” Hogarth said. “Having this minimally invasive option covered by the largest insurer in the state means we can help more patients breathe easier once medications no longer control their disease well.”

The Zephyr Valve is a device that can be used for bronchoscopic lung volume reduction (BLVR), a non-surgical technique that is used to block diseased parts of the lung, allowing healthier parts to take in more air and work more efficiently.

Zephyr valves are inserted in the patient’s airway through the use of a flexible bronchoscope. Functionally, BLVR works similarly to lung volume reduction surgery, but the removal of diseased tissue is not done via surgery.

The U.S. Food and Drug Administration (FDA) approved the Zephyr Valve for adults with severe emphysema in 2018.

The Pulmonx-sponsored clinical trial LIBERATE (NCT01796392), which enrolled 190 people with severe emphysema, compared BLVR using the Zephyr Valve in combination with standard care, to standard care alone. Results from the trial demonstrated that the BLVR treatment induced clinically relevant benefits across multiple domains, including breathlessness and quality of life, as well as in physical functioning.

According to Pulmonx, the Zephyr Valve is available in more than 25 countries, and more than 20,000 patients already have received more than 80,000 of the valves.