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Yahoo
13 hours ago
- Yahoo
Carlsmed's Personalized Spine Implants Get Significant Reimbursement Advantage
Carlsmed Inc. (NASDAQ:CARL), an AI-powered innovator in spine surgery, is poised for significant growth following key advancements and strong analyst projections. The company recently secured additional Medicare reimbursement for its aprevo personalized interbody implants for cervical fusion procedures, effective October 1, enhancing its financial outlook. This favorable reimbursement, granted through the Centers for Medicare & Medicaid Services' (CMS) New Technology Add-On Payment (NTAP) program in the Hospital Inpatient Prospective Payment Systems (IPPS) Final Rule for fiscal year 2026, means cervical fusion procedures using aprevo devices will be eligible for an additional $21,125 beyond standard Medicare Severity-Diagnosis-Related Groups (MS-DRGs) for qualifying inpatient benefit extends to private payors as well, utilizing unique ICD-10-PCS procedure codes. Carlsmed, which priced its initial public offering of 6.7 million shares at $15 per share in July, focuses on AI-enabled personalized spine surgery solutions. Its aprevo cervical system, having received FDA Breakthrough Device designation, is anticipated for a U.S. commercial launch in of America Securities (BofA) has initiated coverage on Carlsmed with a Buy rating and a price forecast of $16, recognizing the company's potential to establish a new standard of care in spine fusion. BofA analyst Travis Steed highlighted Carlsmed's differentiated technology and robust outlook, assigning a premium valuation of 5x 2026 estimated revenue. This premium, higher than recent medtech IPOs and other spine companies, is justified by Carlsmed's projected high revenue growth and strong gross margin profile. BofA conservatively forecasts Carlsmed will add around 20-25 new surgeons each quarter through 2027, indicating a steady increase in adoption. Carlsmed forecasts impressive top-line growth: 66% in 2025 and an annual 40-45% through 2028. Its asset-light business model is expected to support profitability, with gross margins in the mid-70s and capital expenditures at just 1% of sales, significantly lower than the approximately 10% for traditional spine peers. BofA estimates the total spine market at roughly $1.4 billion, with a compound annual growth rate (CAGR) of approximately 1.5%. In the first quarter of 2025, the global spine market (including biologics) saw 2.6% organic growth, driven by a 4.1% increase in the U.S. market. Despite the market being largely commoditized and dominated by major players like Medtronic Plc (NYSE:MDT), Globus Medical Inc (NYSE:GMED), Alphatec Holdings Inc. (NASDAQ:ATEC), Johnson and Johnson (NYSE:JNJ), and Orthofix Medical Inc. (NYSE:OFIX) (who collectively hold about 70% of the market), spine surgeons notably favor new technology. The remaining 30% of the market is split among many smaller companies, creating an opportunity for new market entrants with disruptive technology like Carlsmed's to gain traction. BofA sees significant market share capture potential for Carlsmed, with analyst Steed estimating total revenue of $133 million in 2028, representing only about 1% of the total U.S. spine market. Price Action: CARL stock is trading higher by 0.88% to $13.70 at last check Monday. Read Next:Photo via Shutterstock UNLOCKED: 5 NEW TRADES EVERY WEEK. Click now to get top trade ideas daily, plus unlimited access to cutting-edge tools and strategies to gain an edge in the markets. Get the latest stock analysis from Benzinga? This article Carlsmed's Personalized Spine Implants Get Significant Reimbursement Advantage originally appeared on © 2025 Benzinga does not provide investment advice. All rights reserved. Sign in to access your portfolio
Yahoo
16 hours ago
- Yahoo
A Place At Home Enhances Dementia Care with PocketRN Partnership
National in-home care franchise expands access to dementia care services through new CMS-backed program OMAHA, Neb., Aug. 18, 2025 /PRNewswire/ -- A Place At Home, a senior-focused home care provider franchise, is thrilled to announce a new partnership with PocketRN, a virtual nursing platform supporting the Centers for Medicare & Medicaid Services (CMS) GUIDE Model – a national initiative designed to improve care for individuals living with dementia. Through this innovative partnership, nearly all A Place At Home franchise owners will support the delivery of in-home respite care for families enrolled in GUIDE through PocketRN. Eligible dementia patients and their caregivers will receive access to Medicare-covered respite services provided by A Place At Home, alongside 24/7 virtual nursing support and ongoing caregiver management delivered by PocketRN. The program offers four-hour increments of respite care, totaling up to 72 hours annually, helping families navigate the complexities of dementia care. "Dementia deeply affects the entire family, not just the person diagnosed. Through the CMS GUIDE Model, we're now able to bring meaningful support directly into the home – support that was rarely accessible before," said Dustin Distefano, co-founder and CEO of A Place At Home. "This partnership allows professionally trained caregivers from A Place At Home to provide respite, guidance, and peace of mind to spouses, children, and other family members who are often overwhelmed and under-resourced. It's a powerful step toward caring for the whole family, not just the condition." How It Works Local A Place At Home franchise owners will refer clients with a diagnosis or suspected diagnosis of dementia who are enrolled in Medicare Parts A and B to PocketRN. PocketRN then conducts a comprehensive assessment in alignment with Centers for Medicare & Medicaid Services (CMS) requirements, and once approved, the A Place At Home team conducts a home safety evaluation and initiates care. The initiative also helps alleviate one of the top concerns in caregiving: burnout. According to a recent AARP study, over 84% of family caregivers report that caregiving had a moderate or high impact on the stress they feel daily "Caregiving for a loved one, especially one with dementia, can be overwhelming physically, emotionally, and financially," said Jennifer Axelrod, National Accounts and Growth Strategist at A Place At Home. "This partnership gives families a lifeline. By combining Medicare-covered respite hours with 24/7 access to trained nurses, we're not only expanding care, but we're also helping caregivers breathe, reset, and know they're not alone." This program offers relief, especially during post-hospital transitions, by providing a trained care team while families sort everything out. Franchise owners benefit from full training and bi-weekly webinars to ensure operational readiness. Additionally, after-hours nursing calls are routed directly to PocketRN, improving patient care and reducing administrative burden. "A Place At Home is excited to continue building partnerships like this one to grow upon our mission of helping families when they can't be there," said Axelrod. "It enhances our service offering and empowers our franchisees to deliver an even higher level of compassionate care." For more information about A Place At Home and its services, or to learn more about franchise opportunities, visit About A Place At Home A Place At Home offers a range of customized senior-focused care services, including in-home care, care coordination, and assistance in identifying and transitioning to senior living alternatives. The company is dedicated to preserving the quality of life for seniors by giving them the support they need to stay as independent as possible for as long as possible. Visit for more information. Media Contact: Allyson PiantanidaAPiantanida@ View original content to download multimedia: SOURCE A Place At Home Sign in to access your portfolio
CNBC
18 hours ago
- CNBC
Eli Lilly's 170% UK price hike for Mounjaro is just the start as pharma firms bow to Trump's pricing pressures
Eli Lilly 's move to raise the U.K. list price of its blockbuster diabetes drug Mounjaro marks the start of prices hikes across Europe, analysts say, as pharmaceutical firms respond to U.S. President Donald Trump's drug pricing demands. Lilly said Thursday that it had reached an agreement with the U.K. government to raise the list price of its weekly injection from Sept. 1, while maintaining access for patients covered by the publicly funded National Health Service (NHS). The U.S. pharma giant said it is now working with some other governments to adjust prices by the start of next month, without providing details of the specific countries involved. Analysts expect other firms to follow suit. "Lilly doing this isn't shocking and I think that we'll see more to come," Kavita Patel, NBC News & MSNBC medical contributor and Stanford University professor, told CNBC's "Fast Money" on Thursday. President Trump earlier this month delivered an ultimatum to pharma firms as part of his ongoing campaign to stamp out what he deems as unfair pricing practices in the U.S. In letters sent to 17 major pharmaceutical firms, the president outlined the steps they must take by Sept. 29 to lower the price of U.S. prescription drugs to "most favored nation" (MFN) levels. Lilly's pricing decision takes the U.K. list price of its popular treatment from a range of £92 (about $124.57) to £122 a month, depending on the dose size, to between £133 and £330 — a 170% price jump. That compares to its U.S. list price of $1,079.77 a month, before insurance and other rebates. The U.S. consistently pays the most in the world for many prescription drugs, due in part to the country's highly complex and fragmented reimbursement system, and a lack of the types of national pricing control prevalent in much of Europe. Several European pharma firms have spoken out in support of the White House's pricing demands, with AstraZeneca CEO Pascal Soriot saying last month that Trump was "right" to push for price equalization. Novartis CEO Vas Narasimhan has cited "productive" conversations with the administration, while Roche Chief Executive Thomas Schinecker has suggested that U.S. prices could be cut in half if the government removed intermediaries, known as pharmacy benefit managers (PBMs). Stanford University's Patel noted that firms like Eli Lilly may also be willing to accede to Trump's pricing demands as they seek coverage for their weight loss drugs under forthcoming changes to the U.S. government's Medicare and Medicaid health insurance systems for low-income people and retirees. "The United States is their big market and having that share in both Medicare and Medicaid is everything for drugs like Mounjaro. So this is important and I don't think they'll be the only one that we see," she said. Indeed, rival diabetes and obesity drug giant Novo Nordisk is seeking to regain ground in the lucrative U.S. market after a series of missteps and supply shortages have seen it lose market share to both Lily and other cheaper compounded weight loss drugs. Novo Nordisk 's Chief Financial Officer Karsten Munk Knudsen said earlier this month that Trump's drug pricing demands had "resonated" with the company and that it was already lowering the price of its Wegovy and Ozempic treatments stateside. The company said Monday that it would reduce the cost of Ozempic for cash-paying patients to $499 per month, less than half of its monthly U.S. list price. Nevertheless, Knudsen previously suggested that it could be difficult to simultaneously raise prices in other markets, given stretched public finances and strict pharmaceutical price caps across Europe. "If we look ex-U.S. markets, there's rather limited history in terms of raising prices … I believe it will be challenging to significantly raise prices outside the U.S.," he told CNBC's "Squawk Box Europe." Industry bodies, meanwhile, have warned of the damaging impact sudden prices hikes could have on patient care if implemented to meet Trump's Sept. 29 deadline. Already, U.K. private pharmacies have reported a surge in orders for Lilly's Mounjaro following Thursday's announcement. "Short notice changes to pricing for medicines such as this also have a serious effect on access to an important public health service and pharmacy business themselves," Henry Gregg, chief executive of the U.K.'s National Pharmacy Association, said in a statement. "We are urging the manufacturers to ensure that pharmacies are treated equitably and that proper support is in place," he added.
