Anteris Clears Medicare Hurdle to Fast Track 1,000 Patient Heart Valve Trial

By John Zadeh -

Anteris Technologies clears key reimbursement hurdle for U.S. PARADIGM Trial

Anteris Technologies has secured U.S. Medicare reimbursement eligibility for its global pivotal PARADIGM Trial under a Centers for Medicare & Medicaid Services national coverage policy. Eligible procedures performed at participating U.S. study sites are covered under the Transcatheter Aortic Valve Replacement National Coverage Determination 20.32. This coverage operates under a Coverage with Evidence Development model, enabling reimbursement whilst clinical evidence is generated within the trial.

The company expects this milestone to facilitate U.S. site activation and accelerate operational momentum across participating centres. The trial is registered on ClinicalTrials.gov under identifier NCT07194265.

What is Coverage with Evidence Development and why does it matter?

Coverage with Evidence Development is a CMS framework that allows Medicare to reimburse investigational procedures performed within approved clinical trials. Under this mechanism, hospitals can bill Medicare for procedures conducted as part of qualifying studies, removing the financial burden that would otherwise fall on participating institutions.

Without CED approval, hospitals would bear procedure costs themselves, creating a significant disincentive to participate in clinical research. For Anteris, securing this coverage clears the financial path for U.S. hospitals to activate as PARADIGM Trial sites.

This approval signals regulatory engagement and addresses a common gating factor in pivotal U.S. medtech trials. Reimbursement eligibility typically increases site willingness to enrol patients, directly impacting trial enrollment velocity.

The PARADIGM Trial design

The PARADIGM Trial is a prospective randomised controlled trial comparing the DurAVR Transcatheter Heart Valve against commercially available transcatheter aortic valve replacements. The study will enrol approximately 1,000 patients in the All Comers Randomised Cohort with 1:1 randomisation between the DurAVR THV and commercial TAVR systems.

The trial will assess non-inferiority on a primary composite endpoint measured at one year post-procedure. Key trial parameters include:

  • Enrollment target: Approximately 1,000 patients
  • Randomisation ratio: 1:1 (DurAVR THV vs commercial TAVR)
  • Primary endpoint components: All-cause mortality, all stroke, cardiovascular hospitalisation
  • Assessment timeframe: 1 year post-procedure

This head-to-head study design will generate the first randomised data comparing DurAVR against established market leaders. A positive readout would validate the biomimetic design thesis and support a differentiated commercial position in the structural heart device market.

DurAVR THV and the biomimetic valve thesis

The DurAVR THV is described as the first biomimetic valve, shaped to mimic the performance of a healthy human aortic valve and replicate normal aortic blood flow. The device uses a single piece of moulded ADAPT tissue, Anteris’ patented anti-calcification tissue technology.

ADAPT tissue is FDA-cleared and has been used clinically for over 10 years, distributed for use in over 55,000 patients worldwide. This clinical history provides a foundation of real-world performance data supporting the tissue platform’s safety profile.

The complete DurAVR THV System comprises three components:

  1. The DurAVR valve
  2. ADAPT anti-calcification tissue
  3. The balloon-expandable ComASUR Delivery System

The PARADIGM Trial will test whether the biomimetic design translates into clinical outcomes that match or exceed current-generation TAVR devices. Given TAVR has become the standard of care for many aortic stenosis patients, head-to-head trial data is critical for market entry and commercial differentiation.

What comes next for Anteris

With Medicare reimbursement secured, the company has stated it expects this milestone to facilitate U.S. site activation. The focus now shifts to activating participating centres and enrolling patients across the trial network.

Site activation represents the next visible operational milestone. Investors should monitor enrollment updates as a gauge of trial execution and site engagement.

The PARADIGM Trial aims to establish non-inferiority against commercially available TAVR systems on a composite endpoint at one year. Study completion and data readout timing will depend on enrollment velocity across activated sites.

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Frequently Asked Questions

What is Coverage with Evidence Development and how does it apply to the Anteris PARADIGM Trial?

Coverage with Evidence Development is a CMS framework that allows Medicare to reimburse investigational procedures performed within approved clinical trials, enabling hospitals to bill Medicare rather than absorbing procedure costs themselves. For the PARADIGM Trial, this means eligible DurAVR procedures at U.S. study sites are covered under the Transcatheter Aortic Valve Replacement National Coverage Determination 20.32.

What is the Anteris Technologies PARADIGM Trial and what is it designed to prove?

The PARADIGM Trial is a prospective randomised controlled trial enrolling approximately 1,000 patients in a 1:1 comparison of the DurAVR Transcatheter Heart Valve against commercially available TAVR systems, with a primary composite endpoint — covering all-cause mortality, all stroke, and cardiovascular hospitalisation — assessed at one year post-procedure. The trial is designed to demonstrate non-inferiority of DurAVR against established market-leading TAVR devices.

Why does Medicare reimbursement eligibility matter for the PARADIGM Trial site activation?

Without CED reimbursement approval, hospitals would need to absorb the cost of trial procedures themselves, creating a significant financial disincentive to participate as a study site. Now that Medicare reimbursement is secured, U.S. hospitals can bill for eligible DurAVR procedures, removing this barrier and enabling faster site activation and patient enrollment.

What is the DurAVR THV and what makes it different from existing TAVR devices?

The DurAVR Transcatheter Heart Valve is described as the first biomimetic valve, designed to mimic the performance of a healthy human aortic valve and replicate normal aortic blood flow using a single piece of moulded ADAPT tissue — Anteris' patented anti-calcification technology. ADAPT tissue is FDA-cleared and has been used in over 55,000 patients across more than 10 years of clinical history, distinguishing it from conventional TAVR tissue platforms.

What should investors watch for next following the Anteris Medicare reimbursement announcement?

The immediate next milestone is U.S. site activation at participating PARADIGM Trial centres, followed by patient enrollment commencement and enrollment rate updates. Enrollment velocity will be the key indicator of trial execution progress and will determine the timeline to the one-year primary endpoint data readout.

John Zadeh
By John Zadeh
Founder & CEO
John Zadeh is a investor and media entrepreneur with over a decade in financial markets. As Founder and CEO of StockWire X and Discovery Alert, Australia's largest mining news site, he's built an independent financial publishing group serving investors across the globe.
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