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Search results for: infliximab

U.S. Insurers Often Limit Biosimilar Coverage

Lisa Rapaport  |  

(Reuters Health)—U.S. commercial health plans only covered biosimilar treatments as preferred products in 14% of coverage decisions last year, according to an analysis of publicly available data on coverage decisions.1 Researchers examined records from the Tufts Medical Center Specialty Drug Evidence and Coverage (SPEC) database, which has information on coverage decisions made by 17 of…

Coding Corner Questions: An Office Personnel Quiz

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A 65-year-old male patient diagnosed with rheumatoid arthritis at multiple sites without rheumatoid factor has been ordered to have infliximab infusions. What should support staff do to ensure this procedure can be given to the patient? Make sure there is a signed order from the provider Make sure a prior authorization is obtained Make sure…

Pediatric Cases Require Special Considerations & Aggressive Treatment Plans

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ATLANTA—Managing pediatric patients with rheumatic disease involves special considerations, such as developmental concerns and physiological traits that may affect dosing of medications, according to two experts. During a session at the 2019 ACR/ARP Annual Meeting, Courtney Kremer, ARNP, a pediatric nurse practitioner at the University of Iowa Stead Family Children’s Hospital, Iowa City, and Jessica…

Experts Discuss Current Insurance Issues Challenging Rheumatology

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ATLANTA—From step therapy requirements to infusion center locations to evaluation and management coding, insurance issues bring frequent headaches to clinicians and patients. Experts discussed some of the most recent concerns in a session at the 2019 ACR/ARP Annual Meeting. Chris Phillips, MD, chair of the ACR’s Insurance Subcommittee (ISC), and Gary Bryant, MD, delegate to…

A Combined Immunosuppressive Regimen for ILD MDA5-Positive Dermatomyositis

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Interstitial lung disease accompanied by anti-melanoma differentiation-associated gene 5 positive dermatomyositis is often rapidly progressive and associated with poor prognosis. In this study, a combined immunosuppressive regimen of high-dose glucocorticoids, tacrolimus and intravenous cyclophosphamide proved more effective than treatment with high-dose glucocorticoids and stepwise addition of an immunosuppressant in a historical control group.

Coding Corner Questions: Using NP/PA Services in Practice

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Scenario 1: Direct Billing A 70-year-old female patient with rheumatoid arthritis in multiple joints and positive rheumatoid factor returns to the practice for her fourth infusion of infliximab with the nurse practitioner (NP). She reports no fevers, cough, dyspnea or concurrent illness. She rates the severity of her joint pain at 6 on a 10-point…

Remembering Etanercept & the Advent of the Biologic Era

Robert S. Katz, MD  |  

As a veteran rheumatologist, I remember the clinical trials of etanercept’s (Enbrel’s) efficacy. And when the drug was first approved in 1998, I participated in those clinical trials and realized the effectiveness was astonishing. It was easy to tell which patients were treated with etanercept vs. those who received placebo, even though both groups were…