Author Archives: Todd Cooperman

INSIDE THIS ISSUE Webinar:         •  Solving for Incorrectly Mapped NDC to HCPCS/CPT® Codes And Improperly Reported NDC Units Blog Updates:         •  Hemlibra Introductory Pricing Drugs/Devices:         •  New/Updated Billing and Clinical Information Code Updates:         •  Large Price Changes         •  HCPCS/CPT Codes With Price Changes         •  Reminder – New HCPCS Drug Codes for 2018   WEBINAR Solving for Incorrectly Mapped NDC to HCPCS/CPT® […]

INSIDE THIS ISSUE WEBINAR – February 1st, 2:00PM EST:         • Solving for Incorrectly Mapped NDC to HCPCS/CPT® Codes And Improperly Reported NDC Units Blog Updates:         • Rituxan (Rituximab) Biosimilars – 2018 Drug Pipeline Review         • Trends in FDA approval of Specialty Drugs 1990 through 2017 HCPCS Drug Code Updates:         • Large Price Changes         • Reminder – NEW HCPCS […]

Rituxan (Rituximab) is utilized as one of the treatment options for rheumatoid arthritis (RA), Non-Hodgkins Lymphoma (NHL), Chronic Lymphocytic Leukemia (CLL), and Wegner’s Granulomatosis (WG). In 2016 Rituxan had over $4 billion in sales in the United States, making it a lucrative area for the development of biosimilars.  As of the publication of this article, […]

Intro: There are several publications on the Food and Drug Administration’s (FDA) activities over time, but specific information on specialty drug approvals and trends since 1990 are difficult to find. Our overall purpose for this blog is to review the history of approvals and trends since 1990 for specialty medically covered drug.  Initially, we will […]

Myasthenia Gravis is a neuromuscular disorder that impacts over 50 thousand patients in the United States (U.S.). Of those patients that are diagnosed, approximately 95 percent are treated with immunosuppressants, intravenous immunoglobulin, and/or plasma exchange. The total number of treated patients is expected to grow at an annual rate of 1.7 percent.  Of those patients […]

Are you weighing the decision to enforce an NDC mandate on ALL Medical Pharmacy Claims? RJ Health’s Analytics team shares the pro’s & con’s of NDC mandates across Pricing, Formulary, and Network Quality Considerations. Here are some practical examples to help illustrate how, at the end-of-the-day, RJ Health believes the answer to the NDC vs. […]

On September 14, 2017, the Food and Drug Administration approved the first biosimilar for Genentech’s Avastin® (bevacizumab), which is the first oncological biosimilar product on the U.S. market. Avastin is approved for eight oncological indications, two of which have an orphan drug exclusivity through 2021. The approval of Amgen’s Mvasi™ (bevacizumab-awwb) includes 6 indications (Table […]

On August 3, 2017 the Food and Drug Administration approved a liposome-encapsulated combination of daunorubicin and cytarabine (VYXEOS™, Jazz Pharmaceuticals, Inc.) for the treatment of adults with newly-diagnosed therapy-related acute myeloid leukemia (t-AML) or AML with myelodysplasia-related changes (AML-MRC), which are two types of AML having a poor prognosis. VYXEOS is the first agent that […]

Gain insight on how your organization can apply modest policy adjustments and some straight-forward network engagement tactics to achieve 6% to 10% in savings on Specialty Drug spend. Take the first step to improving medical drug management controls.