ALL DRUG CODES

ALL CODES   A CODE    B CODE    C CODE    CPT CODE    J CODE    NOC CODE    P CODE    Q CODE    S CODE   DRUG COSTS

ELZONRIS – Cost

Elzonris’ HCPCS Code, J9269, became effective in October of 2019. Since it’s HCPCS became effective, Elzonris has taken several minor changes to its list price. The ASP for Elzonris has steadily risen, lagging two quarters behind its WAC price increases.

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DEMEROL – Cost

Demerol is a generic drug aligned to the HCPCS code J2175, which has been effective since the first quarter of 1997. Observing Demerol between 2016-2024, the pricing for certain NDCs aligned to J2150 have taken increases, while others have remained at the same price. Demerol’s average sales price has remained relatively stable across this same time period, increasing by roughly 50% over eight years.

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CYSVIEW – Cost

Cysview’s HCPCS code, A9589, was added and has been effective since January 1, 2019. Since January 2019, the AWP has undergone slight, incremental increases about once per year. The WAC has followed a similar pattern, with incremental increases around the same times. The ASP has indergone some slight fluctuations, rising and falling in very minor amounts, but has overall risen very slightly since the drug’s debut.

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CINQAIR – Cost

Cinquair is aligned to the HCPCS Code J2786, which became effective in January 2017. Cinquair has implemented list price changes every six to twelve months since it became effective. Cinquair’s ASP was first published in the fourth quarter of 2018 within 2-3% of its WAC list price. Cinquair’s average sales price has remained close to its WAC through early 2024.

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CEREZYME – Cost

Cerezyme is aligned to the J Code J1786 which was added and became effective on January 1st, 2011. Cerezyme took several annual list price increases between May 2018 and February 2022. It’s list price has remained steady between February 2022 and January 2024. Cerezyme’s ASP has closely trailed its WAC list price, remaining within a roughly 5% margin.

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BIVIGAM – Cost

Bivigam’s HCPCS Code, J1556, was added and became effective on January 1st, 2014. The WAC and AWP have remained relatively stable since, occasionally taking adjustments. Bivigam’s ASP rose dramatically in January of 2018 nearly doubling in value. Since then, Bivigam’s average sales price has remained relatively stable.

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ZERBAXA – Cost

Zerbaxa is aligned to the J Code: J0695 which became effective in January of 2016. Since it’s effective date, Zerbaxa has taken incremental minor increases to its WAC and AWP list pricing. Although Zerbaxa became effective in January 2016, its ASP was not first published until three years later in January 2019. Zerbaxa’s ASP has steadily risen since its publication, mimicking the increases in list price for Zerbaxa.

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Jemperli – Cost

Jemperli is aligned to the HCPCS Code J9272 which became effective in January of 2022. Jemperli takes biannual list price increases every six months. Between January 2022 and January 2024, these list price changes have occurred in January and July. Jemperli’s average sales price has closely trailed its WAC within a 5% margin.

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XERAVA – Cost

Xerava’s HCPCS code is J0122, and it became was added and became effective October 1, 2019. Between October 2019 and December 2022, the AWP remained consistent. The AWP saw a slight increase in January 2023, and then a sharper increase in January 2024. The WAC has followed a similar trend, seeing a slight increase in January 2023 and a sharper rise in January 2024. The ASP has been slightly less consistent, with small fluctuations month to month. The ASP’s sharpest increases were in July 2022 and July 2023.

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GAMMAPLEX – Cost

Gammaplex is aligned to the HCPCS Code J1557, which became effective in the first quarter of 2012. Gammaplex has historically taken periodic adjustments to its list pricing, roughly once per year. Since it’s effective date, Gammaplex’s average sales price has remained relatively stable, slowly increasing between 2014 and 2024. Gammaplex’s ASP has historically been more than 20% below its WAC, indicating discounting from the manufacturer, Bio Products Laboratory.

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VIVITROL – Cost

Vivitrol is aligned to the J Code: J2315 which became effective in January of 2007. Since May of 2020, Vivitrol has taken roughly annual increases to its WAC and AWP list prices. Vivitrol’s average sales price has remained within 15% of its WAC price over this time period, with increases trailing by two quarters.

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FYARRO – Cost

Fyarro’s HCPCS Code, J9331, became effective in July of 2022. Fyarro’s list price remained consistent until January 2023, when Fyarro took a significant increase to its WAC pricing. Fyarro’s ASP was published in January 2023, within 5% of its WAC pricing. Since then, Fyarro’s average sales price has steadily trailed its WAC price.

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VENOFER – Cost

Venofer HCPCS Code (J1756) became effective in January 2003. Looking back to 2016, Venofer’s list price has remained stable and it’s ASP has slowly decreased. Currently, both American Regent and Fresenius Kabi have NDC codes aligned to Venofer (J1756).

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EOVIST – Cost

Eovist has a HCPCS code of A9581. This HCPCS code was added and became effective January 1, 2010. Between January 2016 and August 2017, the WAC and the AWP remained consistent, and both had a sharp increase in September 2017. From September 2017 to February 2024, both the WAC and the AWP have remained at the same level. Between January 2016 and March 2018, the ASP underwent some slight fluctuations. The ASP underwent a sharp increase in April 2018, but since then has remained fairly consistent with very slight fluctuations.

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TYSABRI – Cost

Tysabri is aligned to the HCPCS code J2323, which became effective in the first quarter of 2008. Between 2016 and 2024, Tysabri has taken minor list price increases every 6 to 12 months. Tyrabri’s ASP has remained relatively close to its WAC price during this time period, indicating a moderate degree of discounting by Biogen.

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TIVDAK – Cost

Tivdak’s J Code, J9273, became effective on April 1st, 2022. Tivdak has taken incremental list price increases every six months. Between Tivdak’s effective date and January 2024, these list price increases have occurred in October and April. Tivdak’s ASP was first published three months after its effective date, in July 2022. Since then, Tivdak’s ASP has closely trailed its WAC indicating a lack of significant discounting.

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INFED – Cost

The HCPCS code for Infed, J1750, was added on December 31st, 2005 but did not become effective until January 1st, 2009. Dating back to January 2016, Infed has taken roughly annual increases to its list pricing of around 5%. Infed’s ASP has trailed its WAC pricing closely.

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Phesgo – Cost

Phesgo’s HCPCS code, J9316, became effective in January of 2021. Between January 2021 and January 2024, Phesgo has not taken any list price increases. The ASP for Phesgo was first published in April 2021 and has closely trailed Phesgo’s WAC list price.

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PERJETA – Cost

Perjeta is aligned to the HCPCS Code J9306, which was added and made effective on January 1st, 2014. Perjeta takes WAC list price changes every 6-12 months of roughly 3-6%. Perjeta’s average sales price closely trails its WAC price indicating a lack of widespread discounting.

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ORENCIA – Cost

Orencia’s HCPCS code is J0129, and it was added January 1, 2007, but first became effective January 1, 2012. Between January 2016 and December 2016, both the AWP and the WAC underwent some slight increases every few months. Between January 2017 and December 2021, both the AWP and the WAC saw increases yearly at roughtly the same rate. Between January 2022 and March 2023, both the AWP and the WAC underwent slight increases and inconsistent intervals. In April 2023, both the AWP and the WAC dropped sharply, which corresponds with a new NDC being added. The AWP and the WAC both rose again sharply in July 2023, dropped sharply again in October 2023, then rose to their highest price in December 2023. The ASP saw slight increases and decreases between January 2016 and June 2021, with an overall upward trend. In July 2021, the ASP dropped very sharply, and has been decreasing in slight increments since.

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OPDUALAG – Cost

Opdualag is aligned to the J Code J9298, which became effective in October of 2022. Opdualag has taken incremental price increases every six months since its effective date. These price increases have historically occurred in January and July. Opdualag average sales price was published in October 2022, the same time that its HCPCS became effective. The ASP for Opdualag has remained close to its WAC price, indicating a lack of significant discounting.

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