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Pfizer Announces Medicare Reimbursement for Inflectra (infliximab-dyyb), the First Biosimilar Monoclonal Antibody Available in the United States

Pfizer  |  January 13, 2017

On Jan. 6, Pfizer Inc. announced that the Centers for Medicare and Medicaid Services (CMS) has included payment information for INFLECTRA (infliximab-dyyb), a biosimilar to REMICADE (infliximab), in its January Average Selling Price (ASP) pricing file. This pricing took effect as of January 1, 2017. Additional claims processing information is listed in the MLN Matters Article Number MM9930.

Wholesaler shipment of INFLECTRA began in the United States (U.S.) on November 21, 2016, and the biosimilar can now be ordered from various national and regional wholesalers across the country. Pfizer is also working with other distribution partners to ensure that INFLECTRA is broadly available to patients and healthcare professionals in the U.S.

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 INFLECTRA is priced at a 15% discount to the current wholesale acquisition cost (WAC) for REMICADE. WAC is not inclusive of discounts to payers, providers, distributors and other purchasing organizations. Additionally, pricing for 340B hospitals is now available.

 To offer further support to patients and healthcare professionals, Pfizer has launched the Pfizer enCompass program, a comprehensive reimbursement service and patient support program offering coding and reimbursement support for providers, co-pay assistance to eligible patients who have commercial insurance that covers INFLECTRA, and financial assistance for eligible uninsured and underinsured patients.

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 INFLECTRA is the first biosimilar monoclonal antibody (mAb) and only the second biosimilar to be available in the U.S.

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Filed under:Biologics/DMARDsDrug Updates Tagged with:Biologics & BiosimilarsCenters for Medicare & Medicaid Services (CMS)InflectraINFLECTRA (infliximab-dyyb)Pfizer Inc.REMICADE (infliximab)

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