CMS Assigns Unique C-code to TECENTRIQ™

A unique C-code that was recently assigned to TECENTRIQ™ (atezolizumab) by the Centers for Medicare & Medicaid Services (CMS). The C-code for TECENTRIQ is C9483 (Injection, atezolizumab, 10 mg).
The unique C-code goes into effect on October 1, 2016. Payers may require its use until a permanent J-code is assigned. The permanent J-code is expected to be available for use starting on January 1, 2018.
The C-code is used primarily in the Medicare hospital outpatient setting. However, some payers accept this C-code instead of unclassified J- or C-codes when billing for TECENTRIQ. Please check with your payers to verify codes and special billing requirements.

Click Here for the TECENTRIQ Billing and Coding Flash Card which contains additional information about coding and billing. Click Here for the full TECENTRIQ Prescribing Information. Dedicated Specialists at TECENTRIQ Access Solutions can be reached at (888) 249‐4918, or visit Genentech-Access.com/TECENTRIQ for more information.

Taiho Patient & Reimbursement Assistance Programs

Taiho Oncology Patient Support offers the following services: 

• Co-pay support for eligible, privately insured patients. Such patients can receive a Taiho Oncology Patient Support Co-pay Card for help with out-of-pocket expenses. 

• Patient Assistance Program. Taiho Patient Support will research financial assistance options for patients with no insurance coverage, insuffi­cient prescription coverage, or insufficient resources to pay for treatment with Lonsurf. Eligible patients may receive Lonsurf at no cost based on assistance, financial, and medical criteria. 

• Alternate funding support. Taiho Patient Support will also refer eligible, publicly insured patients to nonprofit founda­tions that may be able to offer them co-pay assistance.

Click Here for more information on these programs.

Merck's KEYTRUDA Recieves New Indication

On August 5, 2016 Merck announced that the FDA Approves Merck’s KEYTRUDA® (pembrolizumab) for Patients with Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma with Disease Progression on or After Platinum-Containing Chemotherapy.

Please click on the links below for additional information:

Press Release

FDA Approval Letter

Announcement Lette

You are cordially invited to participate in a national webcast followed by a clinical case discussion at select locations, for more information click here. 

Additional Formulation and Indication for EMEND

Merck is pleased to announce that EMEND for oral suspension is now available.

Please click on the links below for more information:

Merck EMEND Announcement Letter 

Prescribing Information

Patient Information

Instructions for Use

FDA Approval for Heron Therapeutics SUSTOL®

On Aug. 10, 2016 Heron Therapeutics, Inc. (NASDAQ:HRTX), announced that the U.S. Food and Drug Administration (FDA) has approved SUSTOL® (granisetron) extended-release injection. SUSTOL is a serotonin-3 (5-HT3) receptor antagonist indicated in combination with other antiemetics in adults for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of moderately emetogenic chemotherapy (MEC) or anthracycline and cyclophosphamide (AC) combination chemotherapy regimens.

SUSTOL is an extended-release, injectable 5-HT3 receptor antagonist that utilizes Heron’s Biochronomer® polymer-based drug delivery technology to maintain therapeutic levels of granisetron for ≥5 days, covering both the acute and delayed phases of chemotherapy-induced nausea and vomiting (CINV).

Click here to read the press release from Heron Therapeutics, Inc. 

CMS Preliminary Decision - Unique J Code for BENDEKA

On April 19, 2016, The Center for Medicare & Medicaid Services (CMS) published a preliminary decision on the HCSPCS application for a unique J code for BENDEKA® (bendamustine hydrochloride) Injection, a ready-to-dilute solution, low-volume (50 mL) bendamustine formulation. CMS ruled that the current J code for TREANDA® (bendamustine HCl) (J9033) appropriately describes BENDEKA. 

This is a preliminary decision and the final CMS decision is expected in the fourth quarter. If a unique J code is recommended at that time for BENDEKA, the effective date would be January 1, 2017.  

As a result of this preliminary ruling, some payers may reimburse BENDEKA using either the J9999 or the J9033 code.  You must adhere to the payer recommendations to determine which code to use for BENDEKA patients. Whatever your decision is regarding coding, it will be important to ensure that the BENDEKA NDC is used on every claim.  

Click here for more information on BENDEKA from Teva. 

New FDA Approval for Opdivo®

On Tuesday, May 17, 2016, Bristol-Myers Squibb Company announced the U.S. Food and Drug Administration (FDA) has approved Opdivo®(nivolumab) for the treatment of patients with classical Hodgkin lymphoma (cHL) who have relapsed or progressed after autologous hematopoietic stem cell transplantation (auto-HSCT) and post-transplantation brentuximab vedotin.This accelerated approval is based on overall response rate. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials. Click Here to read the Press Release from Bristol-Myers Squibb. 

Webcast Invitation from OptumHealth

OptumHealth invites you to participate in the live webcast, Optimal Clinical Strategies for the Treatment of Relapsed Hodgkin’s Lymphoma. 

Please join us on Tuesday, June 14, 2016.
1–2 p.m. Eastern
12–1 p.m. Central
11 a.m.–12 p.m. Mountain
10–11 a.m. Pacific

Intended Audience

This activity is designed to meet the educational needs of physicians, nurses, pharmacists and other health care professionals (HCPs) who have an interest in relapsed Hodgkin’s lymphoma (rHL).

Click Here to view this invitation online.