CHICAGO—“We have got to get over this hump. We have got to try new stuff,” said Jacqueline M. Fritz, RN, MSN, CNS, to the audience gathered on the final day of the 2018 ACR/ARHP Annual Meeting, referring to the subject of biosimilars. Ms. Fritz, the owner and coordinator of education at the Medical Advancement Center…
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RISE Lifts Research: The 2018 Annual Meeting Features 6 New Studies Based on RISE Data
Data from the ACR’s Rheumatology Informatics System for Effectiveness (RISE) were used by rheumatology researchers in a crop of new studies that will be presented at the 2018 ACR/ARHP Annual Meeting, Oct. 19–24 in Chicago. Six abstracts, including four oral and two poster presentations, were accepted for this year’s meeting. They explore topics ranging from…
Study Says 1 Biosimilar Switch Is OK; Jury Still Out on Multiple Switches
AMSTERDAM—As more biosimilar drugs for rheumatic diseases make their way to market, evidence is growing that switching from the originator drug to a biosimilar tends to be effective, while the questions of switching back and forth, and switching multiple times using several different biosimilars, remain to be answered, an expert on the topic said at…
Rheumatology Coding Corner Answer: Billing for an Inflectra Infusion
Take the challenge. CPT codes: 96413, 96415, 96375, Q5103x20, J1200 ICD-10: M07.9 Coding Rationale This procedure is billed with CPT code 96413 for the initial hour of the intravenous infusion and CPT code 96415 for each additional hour. The patient was given 50 mg of diphenhydramine prior to the infusion to prevent reactions and should…
Rheumatology Coding Corner Question: Billing for an Inflectra Infusion
A 68-year-old female patient returns to the office for a second round of Inflectra (infliximab-dyyb) infusion for her rheumatoid arthritis with rheumatoid factor of multiple joints without organ or systems involvement. She reports pain, stiffness and swelling in her left and right knees and right elbow and rates the pain at a 9 on a…
The Science Behind Biosimilars
Although six biosimilar agents have now been approved by the U.S. Food & Drug Administration for use in rheumatology, scientific, clinical, economic and prescribing questions about the use of biosimilars abound. In fact, at the 2017 ACR/ARHP Annual Meeting in San Diego, Joseph Huffstutter, MD, a rheumatologist in private practice in Chattanooga, Tenn., said that…
Health Plans Enact Coverage Policies for Remicade & Infliximab Biosimilars
Several major health plans have recently enacted policies regarding coverage status for Remicade (infliximab) and its biosimilars, Inflectra (infliximab-dyyb) and Renflexis (infliximab-abda). Most of these plans are limiting coverage for the biosimilar products to very specific circumstances. Some have also begun denying claims for biosimilars and instructing patients to switch to Remicade. The plans implementing…
Should Patients with Rheumatic Disease Switch from Biologic to Biosimilar?
SAN DIEGO—Should patients with rheumatic diseases switch from a biologic to its biosimilar? At the 2017 ACR/ARHP Annual Meeting’s Great Debate, held Nov. 5, two rheumatologists argued whether to switch or stay put based on safety, efficacy and potential cost savings. First to the podium to make the case for switching, Jonathan Kay, MD, tweaked…
Biosimilars: Still Waiting for Promise to Materialize
During the 2017 ACR/ARHP Annual Meeting, advances in biosimilar treatments were abuzz. However, many speakers noted that the presence of biosimilars on the market has not yet resulted in greater access to treatment and lower drug pricing in the U.S…
Biosimilars Great Debate: To Switch or Not?
SAN DIEGO—Should patients with rheumatic diseases switch from a biologic to its biosimilar? At the 2017 ACR/ARHP Annual Meeting’s Great Debate, held Nov. 5, two rheumatologists argued whether to switch or stay put based on safety, efficacy and potential cost savings. First to the podium to make the case for switching, Jonathan Kay, MD, tweaked…