While members of Congress debate healthcare legislation, rheumatologists say many of their patients struggle to afford everything from generic drugs to insurance copayments for physical therapy. “It’s a mess. The cost of prescriptions and the rationale for those rising costs in the U.S. right now—it’s just a mess,” says James R. O’Dell, MD, Stokes-Shackleford Professor of…
Take the challenge. CPT: 99213, 96413, 96415 x1, J1745 x 20* ICD-10: M05.09 This encounter is coded as 99213 because: History—The history of present illness is extended. The review of systems is detailed, and two of the three past, family, social history were documented, which makes the history level detailed. Exam—There are four systems examined,…
An 83-year-old established female patient who resides in a skilled nursing facility (SNF) and is diagnosed with rheumatoid arthritis with rheumatoid factor in multiple joints returns to the office for her first infliximab infusion. She denies fevers, cough, dyspnea or concurrent illness, but has joint pain and swelling in both elbows and her left wrist….
A recent study examined the level of anti-drug antibodies (ADAs) in RA patients taking the TNF inhibitors adalimumab, infliximab and etanercept. Study patients without ADAs experienced better clinical outcomes, while patients with detectable ADAs had significantly lower serum trough drug concentrations…
LONDON (Reuters)—Britain’s competition watchdog has accused Merck & Co of operating an unfair discount scheme for its medicine Remicade (infliximab) that it said was designed to restrict competition from so-called biosimilar copies. The Competition and Markets Authority (CMA) says it had provisionally found the U.S. company’s European unit, Merck Sharp & Dohme (MSD), had abused…
A 53-year-old female presented to the clinic for severe polyarticular joint pain and was found to have a seronegative inflammatory arthritis. Six months before, she had completed 10 months of treatment for stage IV metastatic melanoma with the immune checkpoint inhibitors, nivolumab and ipilimumab, achieving complete remission of her cancer. She said that throughout her…
Ipilimumab (Yervoy) is a monoclonal antibody directed against cytotoxic T-lymphocyte antigen 4 (CTLA-4). It was the first drug to demonstrate a survival benefit in advanced melanoma and was approved by the FDA in 2011.1 By blocking the CTLA-4 receptor, ipilimumab enhances the immune response against tumors via cytotoxic T lymphocyte activation and proliferation.2 However, immunopotentiating…
Sirukumab Promising for RA Sirukumab, an investigational human monoclonal antibody that selectively binds to the interleukin (IL) 6 cytokine, has completed a randomized, double-blind, placebo-controlled, parallel-group, Phase 3 clinical trial (SIRROUND-T) in patients with rheumatoid arthritis (RA).1 During the trial, which took place between July 25, 2012, and Jan. 12, 2016, researchers randomized adult patients…
An established patient is seen in the office for a scheduled visit with the rheumatologist at the start of the new year. What should the front desk staff do for all patients at the beginning of each year? Inform the patient that their co-pay is due prior to receiving treatment, and ask how they would…
(Reuters) – Healthcare conglomerate Johnson & Johnson said on Monday the U.S. Department of Justice (DOJ) has opened an investigation concerning management and advisory services provided to rheumatology and gastroenterology practices that bought two of its drugs. The U.S. healthcare company said its Janssen Biotech Inc. unit received a civil investigative demand from the DOJ…