Blue Shield of California Sees the 308-nanometer Light

Blue Shield of California, a plan that covers more than three million people, has approved payment for mild to moderate psoriasis treatment using the PhotoMedex XTRAC laser system.

Since treatment of laser-sensitive lesions may require six to ten office visits, and treatment of resistant lesions may require 20 to 30 office visits, Blue Cross specified reimbursement only in those cases where the patient had failed a previous two-month trial of conservative therapies including topical, oral and injectable medications. A patient’s psoriasis must be limited to ≤ 20% of their body surface area.

This latest decision follows on the heels of a ‘very successful’ year, when similar coverage policies were issued by the Blue Cross Blue Shield Plans in Mississippi, North and South Carolina, Nebraska, Minnesota, Illinois, Texas, New Mexico, Oklahoma and Western New York. The company believes other plans will adopt favorable coverage policies in 2008.

As more insurance companies come on board, PhotoMedex estimates that 1,000 of the 3,200 dermatologists in the U.S. will adopt the XTRAC system. PhotoMedex earns approximately $100,000 per system per year. PhotoMedex installs the XTRAC system in the dermatologists’ office at no initial capital cost, but charges the doctor a per procedure fee.

In lieu of the increased demand in areas where XTRAC has received positive coverage decisions, the company plans to increase its sales force by 50% in 2008.

An estimated seven million Americans are affected by psoriasis and 150,000-250,000 new cases are diagnosed each year. The most prevalent form of disease is plaque psoriasis which appears as raised red skin lesions. The exact cause of psoriasis is unknown but it is thought to be related to problems with the immune system that speed up the growth cycle of skin cells. There is no known cure for the disease. Conventional treatment options involve steroidal creams that require daily applications and are often ineffective and hazardous, or medications that can adversely affect the entire body.

PhotoMedex’s principal product is its 308-nanometer XTRAC excimer laser system. XTRAC was the first FDA approved laser treatment for psoriasis. It is also cleared to treat vitiligo, a pigmentation disorder which results in white patches on the skin.

The laser delivers an ultraviolet B beam of light to the affected skin only, sparing normal skin from exposure. The beam works by suppressing the altered immune cells in the skin that are causing the psoriasis. Six clinical trials show that mild to moderate psoriasis patients can expect a ≥ 75% reduction in PASI (Psoriasis Area and Severity Index) scores with only 6-10 XTRAC treatments. Treated patients remain symptom free for several months on average.

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