Boston Scientific's Watchman device performed well in the recent quarter, but analysts are focused on upcoming reimbursement decisions for the device and the potential impact on Watchman adoption going forward.

Marie Thibault

July 24, 2015

3 Min Read
Analysts Zero in on Watchman Reimbursement

Boston Scientific's Watchman device performed well in the recent quarter, but analysts are focused on upcoming reimbursement decisions for the device and the potential impact on Watchman adoption going forward.

Marie Thibault

Boston Scientific's Watchman Left Atrial Appendage Closure device is the anticipated subject of upcoming reimbursement changes.

Boston Scientific is a large medtech company, with a wide range of products encompassing cardiac, vascular, urology, gastroenterology, and other treatment areas. But anyone listening to the company's recent second quarter earnings call wouldn't have known it, because much of the discussion focused on just one product—the Watchman Left Atrial Appendage Closure device.

More specifically, analysts on the call were looking for details on reimbursement updates expected later this year for Watchman. The device, newly launched in the United States in the second quarter, put up a good result, according to Boston Scientific. According to a Seeking Alpha transcript, Michael Mahoney, president and CEO of Boston Scientific, said, "The first 100 days of the U.S. WATCHMAN launch have been very successful and we expect to complete rollout of the first 100 accounts by year-end. We're very pleased with the implant success rate and the high quality of patient outcomes thus far . . ."

However, future U.S. Watchman adoption is thought to be dependent, at least in part, on positive reimbursement changes. Rick Wise, an analyst with Stifel, recently hosted a conference call with an interventional cardiologist who had implanted the Watchman device. In a July 20 research note, Wise recounted that the physician has implanted 10 atrial fibrillation patients since mid-March but has felt constrained by reimbursement. "Reimbursement uncertainty remains a challenge for BSX's Watchman launch and has limited this clinician's implants to truly warfarin intolerant patient (previous cranial bleeds, etc)," Wise wrote.

Watchman will be the subject of a National Coverage Determination (NCD) and could possibly receive a new technology add-on payment (NTAP). Executives told analysts on the July 23 earnings call that they expect to know more about the NCD and NTAP in the second half of 2015.   

The interventional cardiologist Wise spoke with believes the NCD "will establish a stringent patient implant criteria and could include a TAVR-like 'team approach' requiring institutional participation from cardiologists, neurologists, and radiologists," Wise wrote. Company executives did not give details on what they expect the determination to include. Mahoney said, "We should learn more about the NCD in November with a final decision in first quarter of 2016."

Wise's physician consultant also said he thinks "his center would 'only need to break-even' on Watchman procedures for broader adoption," according to Wise's note.

Mahoney declined to speculate on how likely it is that the add-on payment will be granted, but said that they hope to have "better visibility" on the third quarter earnings call, likely in late October.

Boston Scientific executives also noted that in addition to the NTAP, CMS has also proposed moving Watchman to DRG codes that would pay 20% more than the current code. An update on that potential reassignment is expected to come around the same time as the NTAP update.

Enhance your medtech knowledge by attending MEDevice San Diego, September 1–2, 2015, in San Diego.

Marie Thibault is the associate editor at MD+DI. Reach her at [email protected] and on Twitter @medtechmarie

[Image courtesy of BOSTON SCIENTIFIC CORP.]

About the Author(s)

Marie Thibault

Marie Thibault is the managing editor for Medical Device and Diagnostic Industry and Qmed. Reach her at [email protected] and on Twitter @MedTechMarie.

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