MACs Propose Limiting Coverage for iDose TR — The iDose TR, a 1.8 mm titanium implant, has a nanoporous, ethylene-vinyl acetate membrane designed to allow continuous elution of preservative-free travoprost directly into the anterior chamber.

Five Medicare administrative contractors (MACs) in the US are proposing to limit coverage for procedures implanting the Glaukos iDose TR in patients with glaucoma.

The iDose TR is a drug-eluting intracameral implant designed to continuously deliver therapeutic levels of travoprost for extended periods of time.

The MACs’ proposed local coverage determinations (LCDs) would require patients to fail both selective laser trabeculoplasty and two topical medications before Medicare would cover use of the iDose TR.

It also would prevent the procedure being performed with other eye surgeries or procedures, except phacoemulsification cataract surgery, and the iDose could not be readministered for two years.

The LCDs’ comment period was set to end July 4.

Ophthalmologists weighing in on the proposal include glaucoma specialist Savak Teymoorian, MD, MBA, of California, who said June 24 in an opinion piece on Healio: “Step therapy makes sense for many patients, and starting with SLT is a reasonable first move. But a blanket mandate disservices two kinds of patients: those for whom SLT is not the best option to begin with and those for whom SLT alone is not enough.

“The proposed LCD compounds this problem by requiring both SLT and two failed drops, rather than one or the other, before Medicare will cover iDose TR. The result would be delayed care for patients who need immediate treatment, even as their glaucoma continues to progress,” Teymoorian said.

Glaukos in 2023 set a wholesale acquisition cost for the iDose of $13,950.

Medicare currently has a Medicare Payment Limit for the iDose of $14,717.25.

Glaukos commercially launched the iDose TR in the US in early 2024 after gaining FDA approval in December 2023. The company generated about $136 million in global net sales for the iDose TR platform in 2025.

More News

Want to Read Locked Articles?

Already Have an Account?

Register A Corporate Account

Topics of Interest

Products of Interest