Highmark, an insurer in Pennsylvania, will now cover AppliedVR’s RelieVRx, a device for chronic low back pain, the companies announced Monday. This makes Highmark the first commercial insurer to cover the device.
RelieVRx is an FDA-authorized device. Patients use the device across 56 sessions, which are organized into eight chapters: breath and pain, mind and pain relief, attention and distraction, relaxation, shaping the nervous system toward relief, noticing the body, moving forward, and journey to wellness. The device is self-administered by patients in their homes.
“RelieVRx offers a fully immersive virtual reality experience designed to empower individuals with skills for managing [chronic lower back pain],” said Matthew Stoudt, co-founder and CEO of AppliedVR, in an email. “It serves as a cost-effective, non-pharmacologic adjunctive therapy clinically proven to significantly reduce pain intensity and interference across sociodemographic groups.”
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More than 4 million Highmark commercial members now have access to RelieVRx as a covered therapeutic. Highmark’s choice to cover RelieVRx comes after a comprehensive review of AppliedVR’s clinical research, which included a study involving over 1,000 participants. This research demonstrated that RelieVRx can significantly reduce both pain intensity and interference.
Eligible commercial members at least 18 years old with a diagnosis of moderate to severe chronic low back pain can now receive a prescription for RelieVRx from their healthcare provider without needing prior authorization. AppliedVR declined to share its payment rate for Highmark.
“We are committed to leveraging technology to enhance health outcomes while reducing costs,” said Matt Fickie, senior medical director for Highmark, in a statement. “RelieVRx from AppliedVR provides our members suffering from chronic low back pain a scientifically backed, in-home immersive non-opioid treatment option.”
Currently, more than 72 million Americans have chronic lower back pain. Chronic pain costs the U.S. about $635 billion each year and is a major contributor to the opioid crisis. Stoudt noted that since RelieVRx is a non-pharmacological solution, it can help reduce reliance on opioids in the U.S.
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Digital therapeutics have generally struggled to get insurance coverage. However, AppliedVR took a different route by securing coverage for RelieVRx as durable medical equipment (DME). Healthcare.gov defines DME as equipment and supplies prescribed by healthcare providers for regular use. Other examples include wheelchairs, crutches or blood testing strips.
“That distinction allowed us to be part of an existing benefit category, which made it easier to work with a commercial payer like Highmark to finalize coverage,” Stoudt said. “Secondly, by securing coverage with Highmark — a BCBS plan — we expect it to open doors to secure coverage with other payers — Blues and non Blues.”
Stoudt added that by working with Highmark, the company aims to provide the payer’s members with a chronic lower back pain treatment option that can “produce lasting pain relief while also improving their quality of life.”
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