Pain Unfiltered · American Society of Pain & Neuroscience

The Journey to Commercial Coverage

August 4, 2025·42 min·10 clips

Patrick Buchanan and Timothy Deer open by celebrating more than 20,000 downloads for the podcast. They take the number as a sign that the Aspen community is paying attention. Patrick credits Tim for helping carry the vision. The conversation then turns to guests whose work sits at the intersection of interventional pain, spine care, and reimbursement. A central thread is the path of a therapy and the Mainstay Reactivate device through clinical study, FDA approval, and coverage expansion. The hosts keep coming back to what counts as convincing evidence for decision-makers. Primary outcomes, cost, and whether a therapy can obviate the need for other treatments all come up. Patrick says a payer still has to be shown every barrier before it will engage seriously. He also describes a recent change in tone. Eighteen months earlier, the meetings could be short, with cameras off and little engagement. Now true medical directors are on the call, cameras on, and asking questions. That shift is treated as a real sign of progress. Patrick then asks Jason how he decided to keep raising money for a larger randomized controlled trial. The question folds in investor expectations, earlier studies, and the challenge of funding another major test. Jason explains that he came in during the second half of the original RCT. He also says he later managed the FDA process for approval. He describes using prior studies and experienced clinicians to explain the evidence clearly. After approval, he says, the board was brought together right away. The episode then turns to Dr. Patel and the reasons she chose to work with the company and the device. The closing stretch focuses on how clinical leaders and company leaders speak directly to payers. The guests are thanked for pushing coverage expansion forward. The episode ends with the hope that the same path can help other therapies gain coverage too.

As heard by us

A payer-focused look at how spine evidence becomes coverage, not just approval.

Pain Unfiltered follows how an interventional spine therapy moves from evidence to FDA approval and then into payer coverage, keeping the practical work of getting treatment to patients in clear view.

Read the full review in PlayNext →

Why you'd press play

For the behind-the-scenes push to get a spine therapy from trial data to FDA approval and payer coverage.

Read the full recommendation in PlayNext →

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