DOCSLIB.ORG

Evolving Evidence-Based Treatment Guidelines for Iron Deficiency Anemia in Inflammatory Bowel Disease: Considerations in Managed Care

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Evolving Evidence-Based Treatment Guidelines for Iron Deficiency Anemia in Inflammatory Bowel Disease: Considerations in Managed Care ® SUPPLEMENT July 2021 THE AMERICAN JOURNAL OF MANAGED CARE® Vol. 27 • No. 11, Sup. Evolving Evidence-Based Treatment Guidelines for Iron Deficiency Anemia in Inflammatory Bowel Disease: Considerations in Managed Care HIGHLIGHTS › Diagnosis and Management of Iron Deficiency Anemia in Inflammatory Bowel Disease › Impact of Treatment of Iron Deficiency Anemia in Inflammatory Bowel Disease: Considerations in Managed Care › CE Sample Posttest Supplement to The American Journal of Managed Care® © 2021 Managed Care & Healthcare Communications, LLC Evolving Evidence-Based Treatment Guidelines for Iron Deficiency Anemia in Inflammatory Bowel Disease: Considerations in Managed Care Release date: July 15, 2021 Educational Objectives Expiration date: July 15, 2022 Upon completion of this activity, participants should be able to: • Examine the biologic pathways relevant to iron hemostasis in inflamma- Estimated time to complete activity: 2 hours tory bowel disease (IBD) as well as appropriate monitoring of iron status. Type of activity: Application • Compare iron replacement therapies, including risks and benefits, for the Medium: Print with internet-based posttest, evaluation, and request for treatment of patients with IBD and iron deficiency. credit • Explore the health-related quality of life and economic burden of iron Fee: Free deficiency anemia in relation to the evolving evidence-based treatment protocols for patients with IBD and iron deficiency to improve outcomes This activity is supported by an educational grant from American Regent. and efficiently allocate healthcare resources. Intended Audience Accreditation Statement Pharmacists and managed care professionals Pharmacy Times Continuing Education™ is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a Activity Overview provider of continuing pharmacy education. This activity is Iron deficiency anemia (IDA) is closely linked to inflammatory bowel approved for 2.0 contact hours (0.20 CEU) under the ACPE universal disease (IBD). Treatment often consists of iron replacement therapy, activity number 0290-0000-21-265-H01-P. The activity is available for CE and novel intravenous (IV) iron formulations have impacted the manage- credit through July 15, 2022. ment of patients with both IBD and IDA. Managed care professionals must understand the role of IV iron in treating patients with IBD and IDA, as Obtaining Credit: Participants must read the article, complete the online well as safety and efficacy considerations. This activity will review the posttest and an online evaluation and request for credit. Detailed instruc- role of IV iron replacement in IBD and IDA and focus on the economic tions on obtaining CE credit are included at the end of this activity. burden of these disease states and the impact of IV iron on healthcare resource use. Accreditation/Credit Designation This activity has been planned and implemented in accordance with the Statement of Educational Need accreditation requirements and policies of the Accreditation Council for Inflammation in the gastrointestinal tract can result in iron deficiency Continuing Medical Education (ACCME) through the joint providership anemia (IDA), which is the most common complication of inflamma- of Physicians’ Education Resource®, LLC and Pharmacy Times Continuing tory bowel disease (IBD). Treatment options for IBD can also contribute Education™. Physicians’ Education Resource®, LLC is accredited by the to the condition, with between 36% and 90% of patients with IBD devel- ACCME to provide continuing medical education for physicians. oping IDA. These patients experience higher rates of hospitalization, longer lengths of stay, and high healthcare costs. Managed care profes- Physicians’ Education Resource®, LLC, designates this enduring material sionals should be familiar with newer intravenous (IV) iron replacement for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should therapies that are entering the treatment landscape of iron deficiency claim only the credit commensurate with the extent of their participation in IBD with the potential to reduce healthcare resource utilization and in the activity. lessen disease severity for patients. The market for IV iron is expected to increase considerably through 2026, and payers must be equipped to Physicians’ Education Resource®, LLC, is approved by the California Board address challenges affecting utilization of and access to these therapies, of Registered Nursing, Provider #16669, for 2.0 Contact Hours. such as ensuring access to infusions when products require higher doses. To appropriately individualize the treatment of IDA in patients with IBD, This CE activity is also offered free online at www.ajmc.com/ce and at managed care professionals must recognize the indications, risks, and www.PharmacyTimes.org/go/IBD-AJMC, where you will be directed benefits of IV iron replacement therapies to develop and implement to the activity in its entirety, including the online pretest and posttest, evidence-based pathways and management plans. activity evaluation, and request for credit. Opinions expressed by authors, contributors, and advertisers are their own and not necessarily those of Managed Care & Healthcare Communications, LLC, the editorial staff, or any member of the editorial advisory board. Managed Care & Healthcare Communications, LLC, is not responsible for accuracy of dosages given in articles printed herein. The appearance of advertisements in this publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality, or safety. Managed Care & Healthcare Communications, LLC, disclaims responsibility for any injury to persons or property resulting from any ideas or products referred to in the articles or advertisements. JULY 2021 www.ajmc.com ® SUPPLEMENT July 2021 THE AMERICAN JOURNAL OF MANAGED CARE® Vol. 27 • No. 11, Sup. Evolving Evidence-Based Treatment Guidelines for Iron Deficiency Anemia in Inflammatory Bowel Disease: Considerations in Managed Care TABLE OF CONTENTS OVERVIEW Through this supplement to The American Journal of Participating Faculty S210 Managed Care®, managed care professionals will become Reports more aware of the prevalence of iron deficiency anemia Diagnosis and Management of Iron Deficiency Anemia in inflammatory bowel in Inflammatory Bowel Disease S211 disease and opportunities to optimize care of patients Nicole Bohm, PharmD, BCPS through evidence-based treatment protocols for iron Impact of Treatment of Iron Deficiency Anemia replacement therapies. in Inflammatory Bowel Disease: Considerations in Managed Care S219 Jeenal Patel, PharmD, BCGP CE Sample Posttest S224 A Supplement to The American Journal of Managed Care® PROJ ACE0257 THE AMERICAN JOURNAL OF MANAGED CARE® Supplement VOL. 27, NO. 11 S209 FACULTY & DISCLOSURE FACULTY Nicole Bohm, PharmD, BCPS Jeenal Patel, PharmD, BCGP Associate Professor and Clinical Pharmacy Associate Director, Formulary Design and Specialist, Internal Medicine Strategy Department of Clinical Pharmacy and Outcomes Oscar Health Sciences Lakeland, Florida College of Pharmacy Medical University of South Carolina Charleston, South Carolina MEDICAL WRITING & EDITORIAL SUPPORT Brittany Hoffmann-Eubanks, PharmD, MBA Jenna Wood, PharmD Owner Clinical Pharmacist Banner Medical, LLC Columbus, Ohio Frankfort, Illinois FACULTY DISCLOSURES Nicole Bohm, PharmD, BCPS, has the Jeenal Patel, PharmD, BCGP, has no relevant following relevant financial relationships with financial relationships with commercial interests commercial interests to disclose: to disclose. CONSULTANT Wolters Kluwer, TRC Pharmacist’s Letter MEDICAL WRITING & EDITORIAL SUPPORT DISCLOSURES Brittany Hoffmann-Eubanks, PharmD, Pharmacy Times Continuing Education™ MBA, and Jenna Wood, PharmD, have no Planning Staff: Jim Palatine, RPh, MBA; Maryjo relevant financial relationships with commercial Dixon, RPh; Kimberly Simpson, PharmD; Meg interests to disclose. Taylor, PharmD, CPP; Liz Rauh; Susan Pordon; Brianna Winters; and Chloe Taccetta have no relevant financial relationships with commercial interests to disclose. DISCLOSURE POLICY According to the disclosure policy of Pharmacy Times Continuing Education™ to initiate The American Journal of Managed Care® and a mechanism to resolve the conflict(s). The Pharmacy Times Continuing Education™, all existence of these relationships is not viewed persons who are in a position to control content as implying bias or decreasing the value of the are required to disclose any relevant financial activity. All educational materials are reviewed relationships with commercial interests. If a for fair balance, scientific objectivity of studies conflict is identified, it is the responsibility of reported, and levels of evidence. DISCLOSURE OF UNAPPROVED/OFF-LABEL USE The contents of this activity may include infor- purposes only and is not meant to substitute for mation regarding the use of products that may the independent medical or pharmacy judgment be inconsistent with or outside the approved of a physician or pharmacist relative to diagnostic, labeling for these products in the United States. treatment, or management options for a specific Participants should note that the use of these patient’s medical condition. products outside current approved labeling is considered experimental and they are The opinions expressed in the content are solely advised to consult prescribing information for those of the individual faculty members and these products.
Load more

Recommended publications
  • Suomen Lääketilasto 2019
    SUOMEN LÄÄKETILASTO S LT FINNISH STATISTICS ON MEDICINES FSM 2019 Keskeisiä lukuja lääkkeiden myynnistä ja lääkekorvauksista vuonna 2019 Milj. € Muutos vuodesta 2018, % Lääkkeiden kokonaismyynti 3 460 5,2 avohoidon reseptilääkkeiden myynti (verollisin vähittäismyyntihinnoin) 2 284 4,4 avohoidon itsehoitolääkkeiden myynti (verollisin vähittäismyyntihinnoin) 357 0,8 sairaalamyynti (tukkuohjehinnoin) 818 9,9 Lääkkeistä maksetut korvaukset 1 551 6,2 peruskorvaukset 316 3,0 erityiskorvaukset 1 029 5,2 lisäkorvaukset 205 17,7 Key figures for medicine sales and their reimburssement in 2019 € million Change from 2018, % Total sales of pharmaceuticals 3,460 5.2 prescription medicines in outpatient care (at pharmacy prices with VAT) 2,284 4.4 OTC medicines in outpatient care (at pharmacy prices with VAT) 357 0.8 sales to hospitals (at wholesale prices) 818 9.9 Reimbursement of medicine costs 1,551 6.2 Basic Refunds 316 3.0 Special Refunds 1,029 5.2 Additional Refunds 205 17.7 Lähde: Fimean lääkemyyntirekisteri, Kelan sairausvakuutuskorvausten tilastointitiedosto. Source: Finnish Medicines Agency, Drug Sales Register; Register of Statistical Information on National Health Insurance General Benefit Payments. SUOMEN LÄÄKETILASTO FINNISH STATISTICS ON MEDICINES 2019 Lääkealan turvallisuus- ja kehittämiskeskus Fimea ja Kansaneläkelaitos Finnish Medicines Agency Fimea and Social Insurance Institution Helsinki 2020 LÄÄKEALAN TURVALLISUUS- KANSANELÄKELAITOS JA KEHITTÄMISKESKUS FIMEA FINNISH MEDICINES AGENCY FIMEA SOCIAL INSURANCE INSTITUTION Lääketurvallisuus Analytiikka- ja tilastoryhmä Pharmacovigilance Section for Analytics and Statistics Mannerheimintie 166 Nordenskiöldinkatu 12 P.O. Box 55 P.O. Box 450 FI-00034 Fimea FI-00056 Kela Finland Finland [email protected] [email protected] Puh. 029 522 3341 Puh. 020 634 11 Tel. +358 29 522 3341 Tel.
    [Show full text]
  • Intravenous Iron Replacement Therapy (Feraheme®, Injectafer®, & Monoferric®)
    UnitedHealthcare® Commercial Medical Benefit Drug Policy Intravenous Iron Replacement Therapy (Feraheme®, Injectafer®, & Monoferric®) Policy Number: 2021D0088F Effective Date: July 1, 2021 Instructions for Use Table of Contents Page Community Plan Policy Coverage Rationale ....................................................................... 1 • Intravenous Iron Replacement Therapy (Feraheme®, Definitions ...................................................................................... 3 Injectafer®, & Monoferric®) Applicable Codes .......................................................................... 3 Background.................................................................................... 4 Benefit Considerations .................................................................. 4 Clinical Evidence ........................................................................... 5 U.S. Food and Drug Administration ............................................. 7 Centers for Medicare and Medicaid Services ............................. 8 References ..................................................................................... 8 Policy History/Revision Information ............................................. 9 Instructions for Use ....................................................................... 9 Coverage Rationale See Benefit Considerations This policy refers to the following intravenous iron replacements: Feraheme® (ferumoxytol) Injectafer® (ferric carboxymaltose) Monoferric® (ferric derisomaltose)* The following
    [Show full text]
  • Classification Decisions Taken by the Harmonized System Committee from the 47Th to 60Th Sessions (2011
    CLASSIFICATION DECISIONS TAKEN BY THE HARMONIZED SYSTEM COMMITTEE FROM THE 47TH TO 60TH SESSIONS (2011 - 2018) WORLD CUSTOMS ORGANIZATION Rue du Marché 30 B-1210 Brussels Belgium November 2011 Copyright © 2011 World Customs Organization. All rights reserved. Requests and inquiries concerning translation, reproduction and adaptation rights should be addressed to [email protected]. D/2011/0448/25 The following list contains the classification decisions (other than those subject to a reservation) taken by the Harmonized System Committee ( 47th Session – March 2011) on specific products, together with their related Harmonized System code numbers and, in certain cases, the classification rationale. Advice Parties seeking to import or export merchandise covered by a decision are advised to verify the implementation of the decision by the importing or exporting country, as the case may be. HS codes Classification No Product description Classification considered rationale 1. Preparation, in the form of a powder, consisting of 92 % sugar, 6 % 2106.90 GRIs 1 and 6 black currant powder, anticaking agent, citric acid and black currant flavouring, put up for retail sale in 32-gram sachets, intended to be consumed as a beverage after mixing with hot water. 2. Vanutide cridificar (INN List 100). 3002.20 3. Certain INN products. Chapters 28, 29 (See “INN List 101” at the end of this publication.) and 30 4. Certain INN products. Chapters 13, 29 (See “INN List 102” at the end of this publication.) and 30 5. Certain INN products. Chapters 28, 29, (See “INN List 103” at the end of this publication.) 30, 35 and 39 6. Re-classification of INN products.
    [Show full text]
  • Ferric Maltol) Capsules, for Oral Use ------ADVERSE REACTIONS------Initial U.S
    HIGHLIGHTS OF PRESCRIBING INFORMATION ------------------------WARNINGS AND PRECAUTIONS----------------------- These highlights do not include all the information needed to use • IBD flare: Avoid use in patients with IBD flare (5.1) ACCRUFERTM safely and effectively. See full prescribing • Iron overload: Accidental overdose of iron products is a leading information for ACCRUFER. cause of fatal poisoning in children under 6. Keep out of reach of children. (5.2) ACCRUFER (ferric maltol) capsules, for oral use --------------------------- ADVERSE REACTIONS------------------------------ Initial U.S. Approval: 2019 Most common adverse reactions (incidence > 1%) are flatulence, diarrhea, constipation, feces discolored, abdominal pain, nausea, -----------------------------INDICATIONS AND USAGE-------------------------- vomiting and abdominal discomfort/distension. (6.1) ACCRUFER is an iron replacement product indicated for the treatment of iron deficiency in adults. (1) To report SUSPECTED ADVERSE REACTIONS, contact [name of manufacturer] at [toll-free phone #] or FDA at 1-800-FDA-1088 or ------------------------DOSAGE AND ADMINISTRATION---------------------- www.fda.gov/medwatch. • 30 mg twice daily on an empty stomach (2.1) • Continue as long as necessary to replenish body iron stores (2.1) ------------------------------DRUG INTERACTIONS------------------------------- • Dimercaprol: Avoid concomitant use. (7.2) ---------------------DOSAGE FORMS AND STRENGTHS---------------------- • Oral Medications: Separate administration of ACCRUFER from Capsules:
    [Show full text]
  • Ferric Maltol 30Mg Hard Capsules (Feraccru®) SMC No
    ferric maltol 30mg hard capsules (Feraccru®) SMC No. (1202/16) Shield TX UK Limited 04 November 2016 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use in Scotland. The advice is summarised as follows: ADVICE: following a full submission ferric maltol (Feraccru®) is not recommended for use within NHS Scotland. Indication under review: in adults for the treatment of iron deficiency anaemia (IDA) in patients with inflammatory bowel disease (IBD). In a pooled analysis of two phase III studies in IBD patients with IDA who had failed previous treatment with oral ferrous products, there was a significantly greater increase in haemoglobin concentrations after 12 weeks of ferric maltol treatment compared with placebo. The submitting company did not present sufficiently robust clinical and economic analyses to gain acceptance by SMC. Overleaf is the detailed advice on this product. Chairman, Scottish Medicines Consortium Published 12 December 2016 1 Indication In adults for the treatment of iron deficiency anaemia (IDA) in patients with inflammatory bowel disease (IBD). Dosing Information One capsule twice daily, morning and evening, on an empty stomach. Treatment duration will depend on severity of iron deficiency but generally at least 12 weeks treatment is required. The treatment should be continued as long as necessary to replenish the body iron stores according to blood tests. Ferric maltol capsules should be taken whole on an empty stomach (with half a glass of water) as the absorption of iron is reduced when it is taken with food.
    [Show full text]
  • As Ferric Maltol)
    ANNEX I SUMMARY OF PRODUCT CHARACTERISTICS 1 1. NAME OF THE MEDICINAL PRODUCT Feraccru 30 mg hard capsules 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each capsule contains 30 mg iron (as ferric maltol). Excipient(s) with known effect Each capsule contains 91.5 mg of lactose monohydrate, 0.3 mg of Allura Red AC (E129) and 0.1 mg Sunset Yellow FCF (E 110). For the full list of excipients, see section 6.1. 3. PHARMACEUTICAL FORM Hard capsule. Red capsule (19 mm long x 7 mm diameter) printed “30”. 4. CLINICAL PARTICULARS 4.1 Therapeutic indications Feraccru is indicated in adults for the treatment of iron deficiency. 4.2 Posology and method of administration Posology The recommended dose is one capsule twice daily, morning and evening, on an empty stomach (see section 4.5). Treatment duration will depend on the severity of iron deficiency, but generally at least 12-weeks treatment is required. It is recommended the treatment is continued as long as necessary to replenish the body iron stores according to blood tests. The elderly and patients with hepatic or renal impairment No dose adjustment is needed in elderly patients or patients with renal impairment (eGFR ≥15 ml/min/1.73 m2). No clinical data on the need to adjust the dose in patients with impaired hepatic function and/or renal impairment (eGFR <15 ml/min/1.73 m2) are available (see section 4.4). Paediatric population The safety and efficacy of Feraccru in children (17 years and under) has not yet been established. No data are available Method of administration Oral use.
    [Show full text]
  • Medical Synagis (CPT) [RSV-Igim], for Intramuscular Use, 50 (PA) Mg, Each)
    CCHP Code Brand Name Description (PA) = Prior Authorization required Benefit Notes palivizumab (respiratory syncytial virus 90378 immune globulin Medical Synagis (CPT) [RSV-IgIM], for intramuscular use, 50 (PA) mg, each) lutetium lu 177, dotatate, therapeutic, Medical A9513 Lutathera 1 millicureie (PA) Medical A9590 Azedra Iodine I-131, iobenguane, 1 millicurie (PA) radium ra-223 dichloride, therapeutic, Medical A9606 Xofigo per microcurie (PA) in-line cartridge digestive enzyme for B4105 Relizorb Medical enteral feeding each COCAINE HCI NASAL SOL TOP ADMN 1 C9046 Goprelto Medical MG Medical C9047 Cablivi Injection, caplacizumab-yhdp, 1 mg (PA) Injection, romidepsin, non-lyophilized C9065 Medical (e.g. liquid), 1mg injection, belantamab mafodontin- C9069 Blenrep Medical blmf, 0.5 mg C9070 Monjuvi injection, tafasitamab-cxix, 2 mg Medical Medical C9071 Viltepso Injection, viltolarsen, 10 mg (PA) injection, immune globulin (asceniv), Medical C9072 Asceniv 500 mg (PA) Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car Medical C9073 Tecartus positive viable t cells, including (PA) leukapheresis and dose preparation procedures, per therapeutic dose Effective April 1, 2021 1 CCHP Code Brand Name Description (PA) = Prior Authorization required Benefit Notes prothrombin complex concentrate C9132 Kcentra (human), kcentra, per i.u. of factor ix Medical activity C9248 Cleviprex injection, clevidipine butyrate Medical C9250 Artiss artiss fibrin sealant Medical C9290 Exparel injection, bupivacaine liposome, 1 mg Medical C9293 Voraxaze
    [Show full text]
  • Nutrition and Blood
    Greater Manchester Joint Formulary Chapter 9: Nutrition and Blood For cost information please go to the most recent cost comparison charts Contents 9.1. Anaemias and some other blood disorders 9.2 Fluids and electrolytes 9.3 Not listed 9.4. Oral nutrition 9.5 Minerals 9.6 Vitamins Key Red drug see GMMMG RAG list Click on the symbols to access this list Amber drug see GMMMG RAG list Click on the symbols to access this list Green drug see GMMMG RAG list Click on the symbols to access this list If a medicine is unlicensed this should be highlighted in the template as follows Drug name Not Recommended OTC Over the Counter In line with NHS England guidance, GM do not routinely support prescribing for conditions which are self-limiting or amenable to self-care. For further details see GM commissioning statement. Order of Drug Choice Where there is no preferred 1st line agent provided, the drug choice appears in alphabetical order. Return to contents Chapter 9 – page 1 of 16 V5.2 Greater Manchester Joint Formulary BNF chapter 9 Nutrition and Blood Section 9.1. Anaemias and some other blood disorders Subsection 9.1.1 Iron-deficiency anaemias Subsection 9.1.1.1 Oral iron First choice Ferrous fumarate 322 mg tabs (100 mg iron) Ferrous fumarate 305 mg caps (100 mg iron) Alternatives Ferrous fumarate 210 mg tabs (68 mg iron) Ferrous sulphate 200 mg tabs (65 mg iron) Ferrous fumarate 140 mg sugar free syrup (45 mg of iron/5 mL) Sodium feredetate 190 mg sugar free elixir (27.5 mg of iron/5 mL) Grey drugs Ferric maltol capsules Items which Criterion 2 (see RAG list) are listed as For treatment of iron deficiency anaemia in patients with Grey are intolerance to, or treatment failure with, two oral iron deemed not supplements.
    [Show full text]
  • What Is New Or Changed
    What is Changed or New for the RxFiles? Visit www.RxFiles.ca to get a complete indexed compilation of all our Charts, Newsletters, Q&A’s, Trial summaries & list of references. Table of Contents: 1. Chronological list of some chart changes Jan-Aug 2021 NEW guidelines: New CDN: Sask. SPDP some changes ACC’20 A. Fib or VTE undergoing PCI/ASCVD Aermony RespiClick for asthma -Full: Admelog, Aermony RespiClick, Gluconorm, Spiriva, Suboxone SL, Trintellix ACG’20 Management of Irritable Bowel Syndrome Corzyna for angina -EDS: Adlyxine, Avsola, Dupixent, Fasenra pen, Omnipod Cartridge, Olumiant, ACG’21 Prevent, diagnosis & treat C. difficile infection Combogesic OTC for pain Onpattro, Opsumit, Orkambi, Rituximab (via Riximyo, Ruxience & Truxima), ACG’21 Upper GI & Ulcer Bleeding Dayvigo for sleep Revestive, Soliqua, Takhzyro, Trikafta & Vyndaqel. ACR’21 Treatment of Rheumatoid Arthritis Descovy for HIV PrEP cost: new generics: Actonel DR, Ciprodex, Cytomel, Dovobet oint, Enablex, ADA’21 American Diabetes Guideline Entyvio SC for UC/CD Enoxaparin, Esbriet, Flecainide, Flovent, Humira biosimilars, Hyoscine, AHS’21 Migraine: New Treatments into Practice Kesimpta & Zeposia for MS Infliximab, Jadenu, Kayexalate, Lamivudine, Methotrexate inj, Myforic, ASH’21 Manage VTE: Prevent & Tx pts with Cancer Nextstellis for birth control Onglyza, Pulmicort nebs, Rapaflo, Renvela, Revatio, Rituximab, Tri-Cira, CCS’21 Heart Failure Guideline Update Suboxone Film Uloric, Venofer & Visanne. CCS’21 Lipid Guidelines Trurapi is insulin aspart new NIHB: CTS’21 Management of Very Mild & Mild Asthma New FDA: -Full: Admelog, Campral, Cyclosporine, Dex-4 liquid/gel, Emend, KDIGO’21 Management of Blood Pressure in CKD Aduhelm for Alzhiemer’s Iron polysaccharide complex (Triferexx, Polyride FE, FeraMax), NAEPP’20 American Asthma Guide: Adult/Adolescent Gemtesa for urinary incontinence Mezera 1gm foam, Minocycline, Monurol, Mycophenolate, Nabilone, Kesimpta & Ponvory for MS Shingrix (for age 65-70yrs only), Sirolimus, Tacrolimus, Trintellix, Viread Prevnar 20 for pneumococcal dx & Zyvoxam.
    [Show full text]
  • Healthy U Medical Pharmacy Prior Authorization List
    Below is the list of Medical Drug J-codes that require pre-service review for Healthy U. Please submit requests using the Medical Prior Auth Medical Electronic Request Form (select Medical Pharmacy from the drop down) or the PDF form that are available under Prior Authorization Forms, attach all necessary clinical documentation and submit to the Pharmacy Team by either fax to 801-213-1547 or by email: [email protected] If you have questions or need assistance regarding medical pharmacy please call for 833-981-0212 For questions regarding retail pharmacy please call RealRx pharmacy customer service: 855-856-5694 Procedure Code Description Portal Status 90378 RESPIRATORY SYNCYTIAL VIRUS IG IM 50 MG EA Not Covered 90626 TICK-BORNE ENCEPHALITIS VIRUS VACCINE, INACTIVATED; Not Covered 0.25 ML DOSAGE, FOR INTRAMUSCULAR USE 90627 TICK-BORNE ENCEPHALITIS VIRUS VACCINE, INACTIVATED; Not Covered 0.5 ML DOSAGE, FOR INTRAMUSCULAR USE 90671 PNEUMOCOCCAL CONJUGATE VACCINE, 15 VALENT Auth Required (PCV15), FOR INTRAMUSCUALR USE 90677 PNEUMOCOCCAL CONJUGATE VACCINE, 20 VALENT Auth Required (PCV20), FOR INTRAMUSCUALR USE 90758 ZAIRE EBOLAVIRUS VACCINE, LIVE, FOR INTRAMUSCUALR Not Covered USE 99601 HOME INFUSION/VISIT, 2 HRS Auth Required 99602 HOME INFUSION, EACH ADDTL HR Auth Required 0537T CAR-T THERAPY HRVG BLD DRV T LMPHCYT PR DAY Not Covered 0538T CAR-T THERAPY PREP BLOOD DERIVED T LMPHCYT FOR Not Covered TRANSPORTATION 0539T CAR-T THERAPY RECEIPT & PREP CAR-T CELLS FOR ADMIN Not Covered 0540T CAR-T THERAPY AUTOLOGOUS CELL ADMINISTRATION Not Covered A9276 DISPOSABLE SENSOR, CGM SYS Auth Required A9277 EXTERNAL TRANSMITTER, CGM Auth Required A9278 EXTERNAL RECEIVER, CGM SYS Auth Required A9513 LUTETIUM LU 177, DOTATATE, THERAPEUTIC, 1 MILLICURIE Auth Required 1 This Medical Pharmacy code list is updated regularly, and the Health Plan reserves the right to amend these policies and give notice in accordance with State and Federal requirements.
    [Show full text]
  • The Following Are J Code Requirements
    Updated The following are J Code requirements September 2021 J Codes Auth Required? 20610 - Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa) No A9513 - Lutetium Lu 177, dotatate, therapeutic, 1 mCi Yes A9579 - Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (NOS), per ml No C9036 - Injection, patisiran, 0.1 mg Yes C9062 - Injection, daratumumab 10 mg and hyaluronidase-fihj Yes C9064 - Mitomycin pyelocalyceal instillation, 1 mg Yes C9065 - Injection, romidepsin, non-lypohilized (e.g. liquid), 1mg Yes C9066 - Injection, sacituzumab govitecan-hziy, 10 mg Yes C9069 - Injection, belantamab mafodontin-blmf, 0.5 mg Yes C9070 - Injection, tafasitamab-cxix, 2 mg Yes C9071 - Injection, viltolarsen, 10 mg Yes C9072 - Injection, immune globulin (asceniv), 500 mg Yes C9073 - Brexucabtagene autoleucel, up to 200 million autologous anti-cd19 car positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose Yes C9074 - Injection, lumasiran, 0.5 mg Yes J0129 - Injection, abatacept, 10 mg (code may be used for Medicare when drug administered under the direct supervision of a physician) Yes J0131 - Injection, Acetaminophen, 10 mg No J0133 - Injection, acyclovir, 5 mg No J0150 - Injection, adenosine for therapeutic use, 6 mg (not to be used to report any adenosine phosphate compounds, instead use A9270) No J0171 - Injection, Adrenalin, epinephrine, 0.1 mg No J0178 - Injection, aflibercept, 1 mg No J0485 - Injection,
    [Show full text]
  • Ual Annual Report
    WHEN GREAT MINDS COME TOGETHER, BIG IDEAS COME TO LIFE. 2018 ANNUALUAL REPORTR April 2019 Dear Fellow Shareholders, 2018 was a truly transformative year for our company, highlighted by the achievement of significant milestones toward our goal of advancing care for patients with kidney disease. Leveraging our fully-integrated infrastructure to advance care for patients with kidney disease Through the successful completion of our merger with Keryx Biopharmaceuticals in December 2018, we are now a fully-integrated company with capabilities ranging from research through commercialization. We now have an expanded and highly complementary portfolio focused on addressing significant unmet needs for patients with kidney disease. Our unique assets include Auryxia® (ferric citrate), a U.S. Food and Drug Administration (FDA)-approved product in two indications, and vadadustat, an investigational oral hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) in Phase 3 clinical development, which we believe has the potential to drive a paradigm shift in the treatment of anemia due to chronic kidney disease (CKD). We believe these innovative assets represent exciting growth opportunities for our company. Auryxia: Building on strong momentum Auryxia is the only oral iron tablet approved in the U.S. to treat non-dialysis dependent adult CKD patients for iron deficiency anemia (IDA) and dialysis-dependent adult CKD patients for hyperphosphatemia. During 2018, our commercial team made significant progress in driving uptake of the drug, with volume and share gains for 2018 exceeding those of all other phosphate binders, both branded and generic. Nephrologists have a favorable perception of Auryxia across three of the most important needs in the hyperphosphatemia market: a lower pill burden, a favorable tolerability profile, and a palatable formulation.
    [Show full text]