ARTICLE SUMMARY:
Six years after launching, Boston Scientific’s pioneering Intracept procedure for vertebrogenic chronic low back pain has revenues of roughly $200 million and reimbursement coverage surpassing 200 million lives, including high-profile wins such as HCSC and TRICARE, thanks to a careful, nuanced strategy. Still, major holdouts like UnitedHealthcare and Aetna illustrate the complexity of today’s reimbursement landscape.
When Boston Scientific bought Relievant Medsystems in late 2023 for $850 million in cash up front plus contingency payments through 2025, it had grand ambitions for Intracept, the small company’s pioneering treatment for chronic low back pain (cLBP).
Non-specific or axial cLBP is the third most burdensome condition affecting Americans, following ischemic heart disease and COPD (chronic obstructive pulmonary disease), and it remains a challenge to treat, with success rates generally hovering at less than 30%. While some causes of cLBP are clearly defined, for the most part, its physiology is poorly understood and therefore differentiation of pain generators and treatment breakthroughs that offer sustained pain relief has been frustratingly limited.
Intracept, however, is FDA approved for a specific, well-defined subset of patients with vertebrogenic back pain, which Relievant’s founders were instrumental in identifying. The technology, which is the only treatment designed specifically for this condition, involves a minimally invasive procedure that uses targeted radiofrequency ablation to stop the basivertebral nerve from transmitting pain signals to the brain.
At the time of the deal, Boston Scientific cited Intracept revenues in excess of $70 million and expectations of a year-on-year increase of more than 50%. As of year-end 2025, the product revenues were roughly $200 million, positioning it clearly as an important contributor to its $1.2 billion neuromodulation business (see Figure 1). The backbone of this success depends on sufficient and accessible reimbursement—no small achievement in a field that payors view as a “black hole,” due to concerns about waste and fraud (see box, Vetebrogenic Back Pain is a Specific Diagnosis.)
