To my mind, it's kind of like using a minimally invasive surgical procedure that is already well known and commonly used "off-label" so to speak...i.e. for a condition that it was not developed to treat.
I suppose, going down that same road, using balloon angioplasty to treat MS (or at least MS symptoms) kind of puts it in the category of an "orphan drug," or in this case an "orphan procedure."
Hi, Hope. I have been chewing over that same issue. Using approved surgical procedures for new purposes is different than using a drug off label. Before you can get a drug approved for insurance reimbursement for the new purpose, you need a scientific study. Even that may not be true, though. I need to take tegretol for neuropathic pain. It is prescribed off label (only approved for epilepsy) but my insurance co. pays for it, so that isn't the answer either.
It would seem that Dr.s could do angioplasty, an accepted procedure, for a new application (to relieve CCSVI) and it should be accepted and covered by insurance. I am not sure why this is giving everone so much trouble.
I guess Dr.s need to have approval of their hospital/cath lab to do that procedure, and if there is a real question whether it is useful for any purpose, they may not allow it.
If current imaging thechnology is adequate now to show insufficient blood drainage from the brain cavity (i.e. CCSVI) and angioplasty (i.e. the liberation procedure) it makes rather common sense to fix it.
Plus if the procedure is cnosidered medically necessary, the insurance company should pay for it.
I am having trouble seeing what the problem is.