Learn more about NeuroStar TMS (transcranial magnetic stimulation) Therapy

1. Advancing
the Way
In Treating
Major Depression

2. MDD: A Large Patient Population That Is Currently Being
Underserved
14 Million
MOA
US Adults with MDD
NeuroStar
SYSTEM
7.2 Million
Treated
4 Million
Poorly Served
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
•Inadequate response
•Intolerant to side effects
Kessler RC et al. JAMA. 2003;289(23):3095-3105.
VALUE
OF A
NeuroStar
OTHER
2

3. This means every 20 MDD sufferers…
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
3

4. …15 are not being adequately
treated.
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
4

5. Current Drug Treatment Paradigm
for Depression
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
SSRI
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
Adapted from: Practice Guideline for the Treatment of Patients with Major
Depressive Disorder, 3rd Edition, APA (2010)
5

6. Major Depression
Current Treatment Landscape
With each successive treatment failure, the landscape changes:
MOA
Efficacy, Adverse Events, and Durability
Results With Each Successive Treatment Failure
NeuroStar
High
SYSTEM
Intolerance due to
adverse events
worsens
Likelihood of longterm durability of
benefit declines
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
Likelihood of benefit
from the next option
diminishes
Low
Treatment
Responsive
Disease Staging (# of Tx
Failures)
Trivedi (2006) Am J Psychiatry; Rush (2006) Am J Psychiatry; Fava (2006) Am J Psychiatry;
McGrath (2006) Am J Psychiatry
Treatment
Resistant
VALUE
OF A
NeuroStar
OTHER
6

7. STAR*D Study demonstrates that current
treatment has limited effectiveness
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
Trivedi (2006) Am J Psychiatry; Rush (2006) Am J Psychiatry; Fava (2006) Am J Psychiatry;
McGrath (2006) Am J Psychiatry
7

8. Likelihood of discontinuing treatment
increases with each new medication attempt
MOA
Systemic Drug Side Effects

Weight Gain

Fatigue

Constipation

Headache/
SYSTEM
Migraine

Diarrhea


Nausea
Abnormal
CLINICAL
Ejaculation
DATA

Drowsiness

Impotence

Insomnia


Decreased
Libido


Nervous
Anxiety

Increased
Appetite

Decreased
Appetite
NeuroStar
PRACTICE
Sweating
SUCCESS
PROGRAM
Tremor

Treatment
REIMBURSEDiscontinuation
MENT
Side Effects


WeaknessVALUE
OF A
NeuroStar
Dry Mouth

Dizziness
OTHER
Trivedi (2006) Am J Psychiatry; Rush (2006) Am J Psychiatry; Fava (2006) Am J Psychiatry; McGrath (2006)
Am J Psychiatry; Neuronetics, Inc. (data on file)
8

9. The Burden of Major Depression
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
9
9

10. A Major Burden for Society Today:
Top 10 Causes of Disability
1.
2.
Lower Respiratory Infections
Diarrheal Diseases
3. UNIPOLAR MAJOR DEPRESSION
4.
5.
6.
7.
8.
9.
10.
Ischemic Heart Disease
HIV/AIDS
Cerebrovascular Disease
Premature Birth
Birth Trauma
Road Traffic Accidents
Neonatal Infections
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
The World Health Organization. The World Health Report 2004: Changing History, Annex Table 3:
Burden of disease in DALYs by cause. Geneva: WHO, 2004.
10

11. By 2030…
Top 10 Causes of Disability
1. UNIPOLAR MAJOR DEPRESSION
2.
3.
4.
5.
Ischemic Heart Disease
Road Traffic Accidents
Cerebrovascular Disease
Chronic Obstructive
Pulmonary Disease
6. Lower Respiratory Infections
7. War
8. HIV/AIDS
9. Diabetes
10. Neonatal Infections
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
The World Health Organization. The World Health Report 2004: Changing History, Annex Table 3:
Burden of disease in DALYs by cause. Geneva: WHO, 2004.
11

12. Consumers want alternatives in overcoming
Depression…
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
12

13. NeuroStar TMS Therapy:
An EffectiveTreatment for Depression
• A complete clinical system using a highly
focused pulsed magnetic field to stimulate
NeuroStar
nerve cells in the area of the brain that controls
mood.
MOA
SYSTEM
CLINICAL
DATA
• The first TMS system cleared by the US Food
and Drug Administration (FDA) for the
treatment of patients with major depression
when initial antidepressant medication fails.
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
13

14. NeuroStar TMS Session
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
14

15. UNMET NEEDS
NeuroStar
SYSTEM
Mechanism of Action
CLINICAL DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
15

16. Major Depressive Disorder
UNMET
NEEDS
prefrontal
cortex
anterior
cingulate
cortex
striatum
NeuroStar
SYSTEM
hypothalamus
thalamus
amygdala
brainstem
neurotransmitter
centers
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
hippocampus
VALUE
OF A
NeuroStar
OTHER
16

17. Major Depressive Disorder
UNMET
NEEDS
prefrontal
cortex
anterior
cingulate
cortex
striatum
NeuroStar
hypothalamus
HIGH
thalamus
Neural
Activity
LOW
amygdala
brainstem
neurotransmitter
centers
hippocampus
SYSTEM
In
MDD, some
areas of the
brain are
hypoactive
and others
are
hyperactive.
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
17

18. Major Depressive Disorder
Circuits and Neurotransmitters
UNMET
NEEDS
NeuroStar
monoamine
neurotransmitter
projections
Regions implicated in MDD are
connected to the brainstem via
monoaminergic circuits
When there is an
appropriate
amount of
monoamine
neurotransmitter
activity, neuronal
activity
throughout the
brain functions
normally.
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
Monoamine
Neurotransmitters
Serotonin (5-HT)
Dopamine (DA)
Norepinephrine (NE)
OTHER
18

19. Major Depressive Disorder
Circuits and Neurotransmitters
UNMET
NEEDS
concentration
pleasure/
interests
psychomotor fatigue (physical)
pleasure/interests
psychomotor
fatigue (mental)
sleep
appetite
guilt
suicidality
worthlessness
• Monoamine
dysfunction is
linked to MDD
• Malfunctioning
circuits lead to
specific
symptoms
mood
guilt
suicidality
worthlessness
mood
Monoamine
Neurotransmitters
Serotonin (5-HT)
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
Dopamine (DA)
Norepinephrine (NE)
OTHER

20. Chemical Antidepressants
Therapeutic Effects such as :
UNMET
NEEDS
Antidepressant
increased
concentration
NeuroStar
SYSTEM
CLINICAL
DATA
improved
mood
reduced feelings of
guilt, suicidality,
and worthlessness
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
20

21. Chemical Antidepressants
Antidepressant
UNMET
NEEDS
Side Effects such as:
blurred vision
agitation
insomnia
dry mouth
nausea
GI
distress
sexual
dysfunction
weight
gain
insomnia
fatigue
blood
pressure
changes
NeuroStar
SYSTEM
CLINICAL
DATA
weight gain
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
21

22. NeuroStar Directly Depolarizes
Cortical Neurons
UNMET
NEEDS
Depolarization leads to action potentials in local
neurons and thereby releases neurotransmitters
Neuron
Neurons are
“electrochemical
cells” and respond
to either electrical or
chemical stimulation
Precise pulsed
magnetic fields
from NeuroStar:
• induce a local electric
current in the cortex
which depolarizes
neurons
• elicit action potentials
• cause the release of
chemical
neurotransmitters
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
22

23. NeuroStar Releases Neurotransmitters
in the Brain
These effects
Depolarization of neurons
in the DLPFC causes local
neurotransmitter release
demonstrate
improvements in
depressive symptoms
UNMET
NEEDS
Dorsolateral
prefrontal
cortex
NeuroStar
SYSTEM
Cingulate
cortex
CLINICAL
DATA
Kito (2008) J Neuropsychiatry
Clin Neurosci
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
Depolarization of pyramidal
neurons in the DLPFC causes
neurotransmitter release in
deeper brain neurons
Activation of deeper brain neurons
then exerts secondary effects on
remaining portions of targeted
mood circuits
VALUE
OF A
NeuroStar
OTHER
23

24. Mechanism of Action Summary
UNMET
NEEDS
NeuroStar TMS Therapy…
• Specifically targets the underlying brain circuits involved in
NeuroStar
mood regulation
SYSTEM
• Directly depolarizes cortical neurons and modulates
CLINICAL
neurotransmitter release in the brain
DATA
• Effects involve both the local and deep neural circuits in the
PRACTICE
SUCCESS
brain
PROGRAM
• Accomplishes these effects without unwanted systemic adverse
REIMBURSEeffects
MENT
VALUE
OF A
NeuroStar
OTHER
24

25. TMS Therapy is
not ECT
UNMET
NEEDS
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
25

26. UNMET
NEEDS
The
NeuroStar TMS Therapy
System
MOA
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
26

27. NeuroStar TMS in Clinical Practice
UNMET
NEEDS
• Non-invasive
• No anesthesia or sedation
• Outpatient procedure
easily performed in
psychiatrists‟ offices
• 37-minute daily
procedure (3000 pulses)
• 4-6 week treatment course
• Antidepressant medication
monotherapy may be used for maintenance
MOA
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
27

28. NeuroStar TMS Therapy System
UNMET
NEEDS
MOA
User
Interface
Treatment Coil
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
Mobile Console
VALUE
OF A
NeuroStar
OTHER
28

29. Accurate, Repeatable Positioning
Patented 3D Coil Positioning System
Accurately uses external cranial
landmarks for precise, targeted
repeatable stimulation
• Integrated laser facilitates accurate
alignment of patient‟s head within
head support
• Maintains proper patient
alignment throughout treatment
UNMET
NEEDS
MOA
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
29

30. Designed for Cortical Neuron
Stimulation
Patented Precision
Pulse TMS™
Technology
•
•
•
Proprietary coil design
increases efficiency and
reduces heating to permit high
patient throughput
Focuses stimulation to the
intended target tissue to
maximize safety and efficacy
Electromagnetic pulse duration
designed to stimulate cortical
neurons (<200 microseconds)
UNMET
NEEDS
MOA
<
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
30

31. SenStar®
Key Link to Consistent Treatment
UNMET
NEEDS
SenStar Treatment Link
MOA
MAGNETIC FIELD
DETECTOR
Verifies intensity of the
magnetic field before
every treatment
SENSORY GUARD
Reduces magnetic
field strength at the
scalp
CONTACT SENSOR
Constantly monitors
proper contact to ensure
maximum therapy
SMART CHIP
Signal processor
remembers unique
SenStar ID and
monitors treatment
status
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
HYGIENE BARRIER
OTHER
Layered SenStar Illustration
31

32. SenStar
Real Time Treatment Monitoring
UNMET
NEEDS
SenStar Treatment Link
MOA
Attached to coil, continuously
communicates with the NeuroStar
System, allowing the operator to:
• Verify correct magnetic field strength for
each treatment
• Monitor coil/patient contact to ensure
consistent stimulation of the cortex
• Ensure proper coil to head alignment
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
32

33. Intuitive User Interface
UNMET
NEEDS
NeuroStar TMS
Therapy System
Software
MOA
• Complete software system easily
guides operator step-by-step through
entire treatment workflow
CLINICAL
DATA
• Controls therapeutic settings for safe
and effective treatment
PRACTICE
SUCCESS
PROGRAM
• Automatically stores and recalls
individual patient data for subsequent
treatments
REIMBURSEMENT
• Aids compliance with NINDS Safety
Guidelines*
VALUE
OF A
NeuroStar
OTHER
*Wassermann. Electroencephalography and clinical Neurophysiology, 1996.
33

34. TMS TrakStar™
Simplifies Practice Management
UNMET
NEEDS
TMS TrakStar™ Practice Data Management System
• Centralized patient database for single or multiple NeuroStar
systems
• Tracks NeuroStar treatment history
• Tracks clinical
outcomes
• Produces reports
for patient records,
reimbursement
claims and
communication to
referring physicians
MOA
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
Sample Outcomes Tracking Report
OTHER
34

35. TMS TrakStar™
Stores Data for Single or Multiple Systems
UNMET
NEEDS
MOA
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
35

36. Who Is Neuronetics?
UNMET
NEEDS
• Founded in 2003
• Highly experienced management and
clinical team
• 21 TMS patents
• Significant support from top tier medical
technology investors
MOA
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
36

37. Who Is Neuronetics?
UNMET
NEEDS
• Leader in TMS Therapy innovation, quality,
clinical research, product development and
support
• Pioneered TMS Therapy and made it a clinical
reality in multiple practice settings
• Solely focused on the long term success of
physicians and the health of their patients
MOA
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
37

38. UNMET
NEEDS
MOA
NeuroStar
SYSTEM
Clinical Data
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER

39. Agency for Healthcare Research and Quality
Confirms Evidence Base for Efficacy of TMS
UNMET
NEEDS
• Independent, Peer-reviewed
• 15 TMS clinical trials involving nearly 500 patients
• Average HAM-D decrease in depressive symptoms >5
points vs. sham control
MOA
NeuroStar
SYSTEM
• Meets clinical significance threshold of 3 points on the
HAM-D scale
• Response rate with active TMS was >3x higher than
sham treatment
• Remission rate with active TMS was >6x higher than
sham treatment
“High strength of evidence” for efficacy from well-controlled
RCTs
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
Agency for Healthcare Research and Quality: Comparative Effectiveness Report
on Non-Pharmacologic Treatments for Depression , October 2011
39

40. A Rigorous Clinical Program
to Prove Safety and Efficacy
UNMET
NEEDS
NeuroStar Clinical Development Program
MOA
Acute Efficacy
& Safety Study
(Double Blind,
Sham
Controlled)
Improved
Durability of
Effect Study
Not
Improved
Open-Label
Extension
Study
NeuroStar
SYSTEM
PRACTICE
SUCCESS
PROGRAM
Improved
REIMBURSEMENT
VALUE
OF A
NeuroStar
These studies form the basis for FDA-clearance of the
NeuroStar TMS Therapy System
O‟Reardon, et al. (2007), Biological Psychiatry; Avery, et al. (2007), J Clin Psychiatry; Janicak, et al.
(2010), Brain Stimulation
OTHER
40

41. A Randomized Controlled Trial Conducted
In a “Difficult to Treat” Population
UNMET
NEEDS
TMS monotherapy trial with wash-out period
• Primary diagnosis:
DSM-IV Major Depressive Disorder
• Unipolar type, non-psychotic
• Moderate to severe symptoms at baseline
MOA
NeuroStar
SYSTEM
Indicated patient population (164)
had extensive prior antidepressant drug exposure
• Average number of antidepressant medication trials in current
episode = 4 (range: 1 to 23 attempts)
• Majority of treatment attempts were unable to achieve adequate
dose and duration of treatment due to intolerance
• Indicated patients had failed to achieve satisfactory benefit from
one antidepressant medication at an adequate dose and duration
in the current episode
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
O‟Reardon JP, et al. (2007). Biol Psychiatry 62(11):1208-1216.; Demitrack MA, Thase ME
(2009). Psychopharmacol Bull 42(2):5-38.
41

42. There is evidence between Clear Separation
Active and Sham TreatmentOutcome Measure –
Randomized Controlled Trial Key
UNMET
NEEDS
MADRS Change Score
MOA
NeuroStar
SYSTEM
Greater Than 3
Times Reduction
in Depressive
Symptoms at
Week 4
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
LOCF Analysis of intent-to-treat population
Demitrack and Thase (2009), Psychopharm Bulletin
42

43. Response and Remission Rates
2 to 3 Times Better – Active vs. Sham
UNMET
NEEDS
Randomized Controlled Trial –
Secondary Efficacy Outcomes Response and Remission
Rates for NeuroStar TMS Therapy vs. Sham at 6 Weeks
MOA
NeuroStar
SYSTEM
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
Response = ≥50% improvement at end point compared to baseline score
Remission = HAMD24 total score of <11
= P <0.05
OTHER
*
43
Demitrack MA, Thase ME (2009). Psychopharmacol Bull 42(2):5-38.

44. Significant Response and Remission
Rates
UNMET
NEEDS
HAMD-24 Response and Remission Rates
in the Group Transitioning from Sham to Active Treatment
MOA
NeuroStar
60
SYSTEM
53.3
50
40
37.2
32.6
30
23.3
18.6
20
10
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
7.0
0
Week 2
Week 4
Remission Rate
Week 6
VALUE
OF A
NeuroStar
Response Rate
OTHER
44
Demitrack MA, Thase ME (2009). Psychopharmacol Bull 42(2):5-38.

45. A Proven Safety and Patient Tolerability
Profile
UNMET
NEEDS
Less than 5% discontinuation rate due to adverse events
MOA
Most common adverse event related to TMS is localized pain
or discomfort at or near the treatment area during active TMS
NeuroStar
SYSTEM
• No systemic side effects
• No adverse effect on cognition
Post marketing experience confirms a rare risk of seizure
with TMS treatment
• No seizures reported during NeuroStar clinical studies
(10,000 treatments)
• 0.003% per treatment, <0.1% per patient
• Almost 250,000 treatments to date in post-marketing experience
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
Long-term safety demonstrated in 6 months follow-up
OTHER
Janicak, et al. J Clin Psychiatry, 2008; Janicak, et al. Brain Stimulation, 2010.
46

46. Independent Study Reinforces Efficacy
Optimization of TMS („OPT-TMS‟) Study
UNMET
NEEDS
MOA
Mark S. George, MD; Sarah H. Lisanby, MD; David Avery, MD; William M. McDonald, MD; Valerie
Durkalski, PhD; Martina Pavlicova, Phd; Berry Anderson, Phd, RN; Ziad Nahas, MD; Peter Bulow, MD;
Paul Zarkowski, MD; Paul E. Holtzheimer III, MD; Theresa Schwartz, MS; Harold A. Sackeim, PHD
NeuroStar
SYSTEM
• National Institute of Mental Health (NIMH) sponsored
– Independent of industry
• Rigorous Randomized Controlled Trial
– 190 patients treated at 4 premier academic sites
• Primary outcome measure:
Percent Remission at 3 weeks
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
‒ Active 15% vs. Sham 4% (P = 0.015)
George, Arch Gen Psychiatry, 2010
OTHER
47

47. UNMET
NEEDS
NeuroStar TMS Therapy:
Real World Outcomes
MOA
NeuroStar
SYSTEM
Treatment Utilization and Outcomes Study
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER

48. Naturalistic Study Demonstrates Acute Efficacy
Outcomes in Real-World Clinical Practice
UNMET
NEEDS
• Study goal was to define real world outcomes associated with
NeuroStar TMS Therapy across a broad spectrum of patients and
practitioners
MOA
• Examine acute phase response and one year patient outcomes
• Patient Population & Trial Sites
NeuroStar
SYSTEM
• 307 evaluable unipolar, non-psychotic MDD patients in acute phase
• 42 sites comprised of institutions and private practice
• Study Design Phases
• Acute phase (treatment course driven by patient clinical response)
• Long-term outcomes at 3, 6, 9 and 12 months
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
Carpenter, Depression and Anxiety, 2012
49

49. Patients in this study diagnosed with Major
Depression
UNMET
NEEDS
Patient and Treatment Characteristics
N (%) Female
205 (66.8)
MOA
Age in years, mean (SD)
48.6 (14.2)
Disease and Treatment History N(%)
- Recurrent Major Depression
285 (92.8)
46 (15.0)
NeuroStar
SYSTEM
- Comorbid Anxiety Disorder
Psychiatric Treatment History N(%)
- History of Inpatient Hospitalization
- History of ECT Treatment
Prior Antidepressant Medication Treatment mean (SD)
133 (43.3)
15 (4.9)
2.5 (2.3)
- Average Number of Adequate Treatments in Current Episode
Mean (SD) Number of TMS Sessions During Acute Treatment
28 (10.1)
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
Carpenter, Depression and Anxiety, 2012
50

50. Comparison of End of Acute Treatment Clinical
Status:
Clinician Assessed Outcomes
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
LOCF Analysis of intent-to-treat population
Carpenter (2012), Depression and Anxiety
OTHER
51

51. Comparison of End of Acute Treatment
Clinical Status: Patient-Assessed
Outcomes
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
LOCF Analysis of intent-to-treat population
Carpenter (2012), Depression and Anxiety
OTHER
52

52. Consistent Response & Remission Rates
in a Difficult to Treat Population at end of Acute Phase
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
LOCF Analysis of intent-to-treat population
OTHER
53
Carpenter (2012), Depression and Anxiety

53. Patient Disposition in Outcomes Study
Through 1 Year Follow Up
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
54

54. Long Term Phase Results at 12
Months
UNMET
NEEDS
Outcomes measured for
one year following end of
acute treatment
• Physician directed standard
of care
• 36.2% of patients received
TMS reintroduction
• Average number of TMS
treatment days equals
16
MOA
NeuroStar
SYSTEM
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
Long term durability of effect has not been established in a controlled trial
LOCF Analysis; Neuronetics, Data on file, NCT 00104611
OTHER
55

55. Largest Clinical Data Set of Any TMS Therapy in
Depression
Six studies completed with 800 patients
UNMET
NEEDS
• Two multisite, randomized controlled trials demonstrate clinically
significant antidepressant effect of TMS
• Two open-label extension studies demonstrate consistent results
MOA
• One prospective, naturalistic study confirms results in real-world practice
• One open-label long term follow-up demonstrates safety
NeuroStar TMS Therapy
consistently demonstrates
significant response and
remission rates in a difficult to
treat population:
1 in 2 patients respond
1 in 3 patients achieved complete
remission of symptoms
Avoids many
of the systemic
side effects
typically
associated
with
antidepressant
medications
Excellent safety
profile and
treatment
adherence with
less than 5%
discontinuation
rate due to
adverse events
NeuroStar
SYSTEM
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
O‟Reardon, et al. (2007) Biological Psychiatry; Demitrack & Thase. (2009) Psychopharm Bull; George, Arch Gen Psychiatry, 2010; McDonald WM, et al. (2011)
Depression and Anxiety; Carpenter (2012), Depression and Anxiety; Janicak, et al. (2010) Brain Stimulation; Janicak, et al. (2008) J Clin Psychiatry.
56

56. NeuroStar TMS Therapy is an
Established Therapy Beyond Clinical Trials
UNMET
NEEDS
MOA
• Independent, Peer Review analysis (AHRQ) confirms
efficacy in TMS class
NeuroStar
SYSTEM
• Included in the revised 2010 American Psychiatric
Association (APA) Practice Guideline for the Treatment of
Patients With Major Depressive Disorder
• Several government and commercial payers have developedPRACTICE
SUCCESS
coverage policies for TMS
PROGRAM
• Three CPT 1 codes established for TMS
REIMBURSEMENT
• Approximately 470+ NeuroStar Systems Installed
• Over 11,000 patients safely treated with NeuroStar TMS
VALUE
OF A
Therapy
NeuroStar
OTHER
Agency for Healthcare Research and Quality: Comparative Effectiveness Report on Non-Pharmacologic Treatments for Depression, October 2011;
Practice Guideline for the Treatment of Patients with Major Depressive Disorder, 3 rd Edition (2010) American Psychiatric Association;
57

57. NeuroStar TMS Therapy: Indication for
Use
The NeuroStar TMS System is
indicated for the treatment of adult
patients with Major Depressive
Disorder (MDD) who have failed to
receive satisfactory improvement from
one prior antidepressant medication at
or above the minimal effective dose
and duration in the current episode…
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
”
Nearly all patients received multiple inadequate
treatment attempts in current episode
(range: 1 to 23 attempts, avg: 4)
Demitrack & Thase. (2009) Psychopharm Bull
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
58

58. TMS is Included in Practice
Guidelines
Following Failure of Initial Treatment
UNMET
NEEDS
Guideline Sources
MOA
“…Acute phase treatment may include pharmacotherapy, depressionfocused psychotherapy, the combination of medications and
psychotherapy, or other somatic therapies such as electroconvulsive
therapy (ECT), transcranial magnetic stimulation (TMS), or light
therapy…”
NeuroStar
SYSTEM
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
Schlaepfer, et al. World J Biol Psychiatry (2009); Kennedy, et al J Aff Disorders (2009);
American Psychiatric Association (2010)
59

59. Top Psychiatry Facilities Provide
NeuroStar TMS Therapy
UNMET
NEEDS
MOA
• Johns Hopkins Hospital, Baltimore, Maryland
• McLean Hospital, Belmont, Massachusetts
• Sheppard and Enoch Pratt Hospital, Baltimore, Maryland
• Mayo Clinic, Rochester, Minnesota
• UCLA, Los Angeles, California
NeuroStar
SYSTEM
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
Other notable hospitals and institutions include: Stanford Hospital, Alegent Health,
Berenson-Allen Center for Noninvasive Brain Stimulation (Beth Israel DMC), Florida
Hospital, University of Michigan, Butler Hospital/Brown University, Medical University of
South Carolina, Rush University, Walter Reed, University of Florida, Loma Linda
University, Boston University, University of South Florida and Southern Illinois University,
VALUE
OF A
NeuroStar
OTHER
60

60. Patient Experiences with NeuroStar
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
61

61. Best Practices Treatment Guideline for Depression
Based on 2010 APA guidelines and NeuroStar TMS Therapy
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
SSRI
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
Adapted from: Practice Guideline for the Treatment of Patients with
Major Depressive Disorder, 3rd Edition, APA (2010)
62

62. Who is the NeuroStar TMS Therapy
Patient?
UNMET
NEEDS
MOA
• In a recurrent episode of depression
• Has had many medication attempts, yet remains
NeuroStar
SYSTEM
symptomatic
• Due to intolerance, patient has only been able to take one
medication at adequate dose and duration
• Considering a complex multi-drug regimen but concerned PRACTICE
SUCCESS
about side effects:
PROGRAM
• Adding another antidepressant medication
REIMBURSEMENT
• Stepping up to an atypical antipsychotic or patient has
already failed to benefit from one
VALUE
OF A
• Demonstrates motivation for change
NeuroStar
OTHER
63

63. Who is a NeuroStar TMS Therapy
Patient
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
64

64. Sarah G. Age 37
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
Sarah G was first diagnosed with depression at age 20. This
recurrent episode was precipitated by dealing with infertility. She
tried an SSRI for eight weeks which worked in the past but not in
this episode. She has added duloxetine and bupropion, but could
not tolerate the side effects and remains symptomatic with
difficulty sleeping. She is a school administrator, enjoys her job
and loves the benefits of the school calendar. She really wants to
get better so she and her husband can begin the adoption
process and start a family.
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
65

65. George T. Age 52
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
George T is a computer programmer for a fast paced, high tech
company. He loves his job and it makes him feel young at age 52.
He has had depression for many years and good success with
medications in the past. In this episode however, the drugs are
just not working, even after many medication attempts, one of
which was even for 8 weeks. He even tried an augmentation
therapy with an atypical antipsychotic in this episode but had to
stop due to weight gain and rising blood glucose levels. He has a
family history of diabetes. He is highly motivated to pursue new
treatment options because he wants to be in the game at the
office.
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
66

66. Julie A. Age 49
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
Julie A is a classic middle aged mom, chasing her teenagers and
worrying about her elderly parents. She is teaching her 17 yearold son to drive a car and wonders how she ever got to be age 49!
She was first diagnosed with MDD in her early thirties along with
generalized anxiety. In this recurrent episode, she has tried many
medications but was only able to stay on one for 6 weeks at the
right dose. And after all that work to stay on the medication,
it just did not make her feel better. The other medications left her
in a fog. Julie is motivated to get well because she wants to
remain engaged with her busy family and to be there when her
son passes his driver’s test.
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
67

67. NeuroStar TMS Therapy Summary
NeuroStar TMS Therapy is:
• An effective, proven treatment for
major depression when initial drug
treatment fails
• Included in APA Practice Guidelines
•A valuable treatment for patients with
depression who want to reduce
medications and their side effect
burden
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
68

68. UNMET
NEEDS
NeuroStar TMS Therapy
Practice Success
Program
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER

69. NeuroStar Practice Success Program
Purpose: Accelerate
integration of Neurostar TMS
Therapy into a psychiatric
practice utilizing a structured
six stage process.
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
REIMBURSEMENT
Through a focused six stage process, each with clear
milestones, the practice is given a roadmap toward
creating a successful NeuroStar TMS clinic.
VALUE
OF A
NeuroStar
OTHER
70

70. Practice Success Program
Resources
UNMET
NEEDS
•Neuronetics TMS Specialist: Assigned
to the practice to drive the process
•Practice resources: Physician, TMS
Coordinator and practice staff align on
roles and practice goals
•PSP tool set: From clinical training
through NeuroStar TMS consultations to
tips on marketing the practice
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
71

71. Stage 1 – Planning and
Installation
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
• Your TMS Specialist will partner with you from
the very beginning
• You‟ll benefit from our experience as you plan
the integration of your NeuroStar System into
your practice
CLINICAL
DATA
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
72

72. ®
StarGuard
Field Service
UNMET
NEEDS
• “Turn-key” installation
process
• 24/7 hotline to our fast,
responsive local service
• Service representatives
located throughout the
U.S.
• Always have access to the
latest NeuroStar TMS
technology for your
patients
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
73

73. Stage 2 – Online and Staff Training
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
• Build a strong foundation for your NeuroStar practice through
comprehensive staff training, including training on patient
finance resources
• Understand best practices for identifying NeuroStar patients
and developing a TMS intake process
• Begin online clinical training through NeuroStar University
CLINICAL
DATA
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
74

74. Stage 3 – Consult Training
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
• Understand the dynamics of a NeuroStar TMS consultation
• Complete review of NeuroStar patient education materials
CLINICAL
DATA
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
75

75. Patient Education
UNMET
NEEDS
• Wide range of patientfriendly educational
materials
• Provide your patients the
knowledge they need to
understand NeuroStar
TMS Therapy
• Help facilitate patient decision-making about choosing
NeuroStar TMS Therapy with your guidance
• Assist family members in understanding NeuroStar TMS
Therapy
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
76

76. Patient Financing Options
• Financing is available for
NeuroStar TMS Therapy which
meets the individual needs
• Creates greater access to your
practice, reduces the barriers to
treatment
• Allows consumers to bring the
benefits of NeuroStar to more
patients
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
77

77. Stage 4 – Clinical Training
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
• Master the use of the NeuroStar System through our on-site
Clinical Training
• Performed right in your office with actual NeuroStar patients
CLINICAL
DATA
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
78

78. NeuroStar University
Clinical Training & Support
UNMET
NEEDS
• Deliver NeuroStar TMS Therapy to your
patients knowing you have received top quality NeuroStar
training
• Provide the highest
quality clinical care to
your patients
• Position yourself as a
leader in the emerging
new field of “interventional
psychiatry”
MOA
SYSTEM
CLINICAL
DATA
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
79

79. Stage 5 – Outcome Analysis
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
• Utilize TMS TrakStar™ Practice Data
Management Software to track your outcomes
as you prepare to educate your community
about NeuroStar TMS Therapy
• Track your outcomes for patient, referring
physician and reimbursement purposes
CLINICAL
DATA
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
80

80. Stage 6 – Increasing Awareness
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
• Grow your NeuroStar practice by increasing
TMS awareness in your community
• Utilize tools and resources to educate
referring physicians and reach new patients
CLINICAL
DATA
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
81

81. Public Relations & Local Outreach
UNMET
NEEDS
• Neuronetics works in many geographic areas to obtain local TV MOA
and newspaper articles about NeuroStar TMS Therapy
NeuroStar
• Your NeuroStar practice can benefit from our media outreach SYSTEM
and community awareness
CLINICAL
• Enhance your reputation in the community as a mental health
DATA
treatment expert
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
82

82. NeuroStar in the News
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
REIMBURSEMENT
VALUE
OF A
NeuroStar
http://neurostar.com/hcp/news-events-exhibits/recent-press-coverage/
OTHER
83

83. NeuroStar In The News
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
84

84. NeuroStar Practice Success Program
• Neuronetics team is available to you
24/7 for service and support whenever
you need it
• We are your partner in helping you to
build a successful NeuroStar TMS
Therapy practice
• We support you every step
of the way with a variety of
programs, services and tools
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
REIMBURSEMENT
VALUE
OF A
NeuroStar
OTHER
85

85. Reimbursement Support Services
UNMET
NEEDS
MOA
• Insurance Reimbursement is a complex process
• The Neuronetics Reimbursement Team is committed to NeuroStar
SYSTEM
NeuroStar
providing support in all areas:
Reimbursement
Managers
PROVIDER
FOCUSED SUPPORT
 Provides
education and
individual office
support
 Provides general
coding, billing,
prior authorization
and appeals
assistance
Health Policy
Team
Reimbursement
Support (NRS)
PAYER
FACING SUPPORT
Works with
Payers to obtain
coverage
policies
Works with the
Provider to
develop Payer
Advocates
SUPPORT SERVICES
HOTLINE
 Team who
provides general
reimbursement
support services
Conducts
insurance
Benefits
Investigation in
your office
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
VALUE
OF A
NeuroStar
OTHER
O‟Reardon JP, et al. (2007). Biol Psychiatry 62(11):1208-1216.; Demitrack MA, Thase ME
(2009). Psychopharmacol Bull 42(2):5-38.
86

86. CPT Category I Codes
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
VALUE
OF A
NeuroStar
OTHER
87

87. Progress Toward Broader Coverage
UNMET
NEEDS
• Tremendous momentum with both commercial and government MOA
payers issuing coverage policies for NeuroStar TMS Therapy
NeuroStar
• Neuronetics works closely with interested NeuroStar providers SYSTEM
to educate insurers in their region
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
Neuronetics provides no guarantee of insurance coverage. Coverage
guidelines vary with each payer according to the patient’s individual
benefits plan, medical necessity and local reimbursement policies. It is the
responsibility of the physician or facility to contact each carrier regarding
the plan’s specific guidelines and policies.
VALUE
OF A
NeuroStar
OTHER
88

88. What does NRS do?
UNMET
NEEDS
NeuroStar Reimbursement Services
Provides These Basic Services
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
VALUE
OF A
NeuroStar
OTHER
89

89. The Value of NeuroStar
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
OTHER
90

90. Financial Overview
Specific Treatment Volumes, Revenues and Expenses Are Hypothetical Examples Only and Neuronetics
Makes No Representation or Warranty That These Examples Will Apply In Your Circumstances
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
*Maximum System Capacity = 8 patients/day = 8 patients/month.
**Neuronetics, Inc. does not determine the reimbursement or revenue per treatment for TMS Therapy. These ranges of revenue
per treatment session are not definitive, are based on limited information, and may not apply to a particular provider or patient.
Neuronetics does not endorse or advocate for any particular pricing or reimbursement structure with our customers and we are
not able to advise on the reimbursement rates providers will receive in particular cases.
OTHER
91

91. Flexible Financing
UNMET
NEEDS
• Flexible equipment
leasing options are
NeuroStar
available from financial
groups who work with
psychiatrists
• Easy monthly payments improve cash flow
• Offer the benefits of NeuroStar TMS Therapy to
your patients without the financial burden of a
capital equipment purchase
MOA
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
OTHER
92

92. NeuroStar System Investment
NeuroStar TMS Therapy
System
• Mobile console w/touch screen
graphical user interface
• Precision Pulse™ TMS
Technology
• Adjustable, ergonomic patient
chair
• 3D Coil positioning system
• NeuroStar TMS Therapy
System Software
• TMS TrakStar™ Patient Data
Management System
• Installation and two-year limited
warranty
• Neuronetics Service & Support
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
OTHER
93

93. Summary
UNMET
NEEDS
MOA
• The NeuroStar TMS Therapy System is the first FDA-cleared
non-systemic and non-invasive TMS device for the treatment ofNeuroStar
SYSTEM
Major Depression
• NeuroStar is demonstrated to be effective and safe in the
treatment of patients with MDD who had failed to benefit from
initial antidepressant medication
• Neuronetics partners with you and provides our complete
wraparound services to successfully integrate NeuroStar TMS
Therapy into your practice
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
OTHER
94

94. Prescribing and Safety Information
UNMET
NEEDS
• Refer to www.NeuroStar.com for complete prescribing and product safety
information
• NeuroStar TMS Therapy is contraindicated in patients that have non-removable
conductive metal in or near the head.
MOA
NeuroStar
SYSTEM
• Patients treated with TMS Therapy should be monitored for symptoms of worsening
depression
CLINICAL
DATA
• There is a rare risk of seizure with TMS Therapy (0.1% of acute treatment course)
PRACTICE
SUCCESS
PROGRAM
• NeuroStar TMS Therapy has not been studied in patients who have not received
initial antidepressant treatment and has not been shown to be effective in patients
outside the indicated population for use
REIMBURSEMENT
• NeuroStar TMS Therapy is not appropriate for all patients with depression; patients
VALUE
should be evaluated by their physician to determine if TMS Therapy is an appropriate OF A
NeuroStar
treatment option
• NeuroStar TMS Therapy is available by prescription only
OTHER
95

95. UNMET
NEEDS
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
Thank You
VALUE
OF A
NeuroStar
OTHER
96

96. UNMET
NEEDS
MOA
NeuroStar
SYSTEM
Competitive Review
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar

97. Brainsway Offers Minimal Increase
in Magnetic Field Depth
• Brainsway device uses a variation of research air-cooled coil
technology, known as a Hesed coil (H-Coil)
• Vastly different than the first to market patented solid
ferromagnetic coil technology used by the NeuroStar System.
• Coil uses multiple magnets to produce a diffuse magnetic field
• Brainsway coil stimulates
greater volume of brain
tissue and reaches
approximately
0.5 cm deeper
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
Neuronetics, Data on File.
98

98. Brainsway Offers Minimal Increase
in Magnetic Field Depth
UNMET
NEEDS
• Brainsway‟s claim to reach deeper brain
structures is misleading
NeuroStar Depth
Brainsway Depth
• Majority of tissue
stimulated is not
associated with relevant
deep-brain structures
thought to be involved
in mood regulation
(i.e. the limbic system)
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
99

99. NeuroStar TMS Therapy:
A Targeted Mechanism of Action
Patented solid ferromagnetic
coil technology used by the
NeuroStar System allows
targeted stimulation of cortical
neurons in brain structures
associated with mood.
• Precise pulsed magnetic fields induce small electric currents in
the prefrontal cortex of the brain
• Local neurons depolarize which leads to activation of deep brain
structures via trans-synaptic pathways
• Activation of these pathways in the limbic system leads to the
release of neurotransmitters
• Blood flow and glucose metabolism rise in the activated
regions, which is thought to result in improved mood
Kito (2008), Journal of Neuopsychiatry and Clinical Neuroscience.
UNMET
NEEDS
MOA
NeuroStar
SYSTEM
CLINICAL
DATA
PRACTICE
SUCCESS
PROGRAM
REIMBURSEMENT
VALUE
OF A
NeuroStar
100