KING OF PRUSSIA, PA — Global biotherapeutics leader CSL Behring announced that the Centers for Medicare & Medicaid Services (CMS) has approved Hizentra for coverage under Medicare Part B for the treatment of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). The new coverage, which is effective for dates of service on or after July 18, 2021, will reduce out-of-pocket costs for patients and includes coverage of the self-infusion pump, supplies, medication and nurse training. Hizentra will be the only self-infusion treatment for CIDP covered under the same benefit category as other Ig CIDP treatment options.
“We believe this decision by CMS is in the best interest of patients and will improve access to Hizentra, which is directly aligned with our purpose and a central part of our promise to patients,” said Bob Lojewski, Senior Vice President and General Manager, North America, CSL Behring. “Thanks to CMS, patients will now experience reduced out-of-pocket costs and have better access to a therapy that gives them the flexibility to self-administer their treatment at a time, place and on a schedule that’s convenient for them.”
People living with CIDP require regular infusions of immune globulin replacement therapy to maintain their health. Prior to the CMS decision to cover Hizentra under Medicare Part B, Hizentra has been covered under Medicare Part D, meaning that many patients experience higher out-of-pocket costs associated with their treatment and certain medical equipment, such as the self-infusion pump. Patients with Medicare Part B and Medigap or supplemental coverage will see a significant reduction in out-of-pocket expenses as compared to Part D with this new coverage.
“A large focus of the GBS|CIDP Foundation International is ensuring that policy decisions reflect the needs of our patient community and we believe decisions like this by CMS are a step in the right direction for the benefit of patients,” said Lisa Butler, Executive Director, GBS|CIDP Foundation International. “People with CIDP may face barriers in their day-to-day life, but access to treatment should not be one of them.”
The referral process for Hizentra will now be easier for physicians, since no prior authorization will be required. CSL Behring also offers Hizentra ConnectSM, a comprehensive resource center for patients who need assistance applying for Medicare Part B coverage and for physicians who have questions regarding referral to specialty pharmacies, coding and billing, nurse training and financial assistance.
“It is important to have an open dialogue with patients about treatment options,” said Jeffrey Allen, M.D., Department of Neurology, Neuromuscular Medicine, University of Minnesota. “Now that Hizentra will have the same Medicare coverage as an IVIg, physicians and patients may be able to more easily find the option that is best for them.”
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