ALL DRUG CODES

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

OPFOLDA – Cost

OPFOLDA, HCPCS J1202, became effective on April 1, 2024, and has three NDCs mapped to J Code: J1202. There has been no change in pricing since inception. AWP has remained slightly higher than WAC.

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RYKINDO – Cost

RYKINDO, became effective on April 1, 2024, and is associated with HCPCS J2801. RYKINDO has six NDCs mapped to J Code: 2801 with no discrepancies found within these alignments. Pricing between WAC and AWP have remained relatively close with no substantial movement.

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Veopoz – Cost

Veopoz, manufactured by REGENERON PHARMACEUTICALS, became effective on April 1, 2024 and is associated with HCPCS J9376. Veopoz has two NDCs aligned to J Code: J9376. Since inception, pricing has remained level with AWP being 20% higher than WAC.

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CEFAZOLIN – Cost

CEFAZOLIN’s HCPCS J0688, became effective on January 1, 2024. CEFAZOLIN has two NDCs aligned to J Code: J0688 with no errors found. ASP has held just over 30% below WAC.

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REZZAYO – Cost

REZZAYO, a product of MELINTA THERAPEUTICS, LLC, became effective on October 1, 2023 and is aligned to J Code: J0349. From the end of 2023 through the first quarter of 2024, prices have remained steadt.

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SINCALIDE – Cost

SINCALIDE, became effective on July 1, 2023, and is associated with HCPCS J2806. There are two NDCs aligned to J Code: J2806 with one possible error found within these mappings. Prices have remained level through the beginning of 2024.

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BYFAVO – Cost

BYFAVO’s HCPCS became effective on July 1, 2023. There are two NDCs aligned to J Code: J2249 with one possible error or discrepancy found. AWP and WAC have remained level at their introductory prices through the first quarter of 2024.

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FUROSCIX – Cost

FUROSCIX, manufactured by SCPHARMACEUTICALS, became effective on July 1, 2023, and is aligned to J Code: J1941. Through the end of 2023, both WAC and AWP remained unchanged. At the beginning of 2024, both experienced a slight increase of roughly 10%.

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ALFENTA – Cost

ALFENTA, became effective on July 1, 2023, and is associated with HCPCS J0216. ALFENTA has two NDCs aligned to J Code: J0216 with potential errors found within both of these mappings.

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SEZABY – Cost

SEZABY, a product of SUN PHARMACEUTICALS, became effective on July 1, 2023, and is aligned to HCPCS J2561. There have been no significant price changes through 2024. Both WAC and AWP remain relatively close.

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EYLEA HD – Cost

EYLEA HD’s HCPCS: J0177, became effective on April 1, 2024. From its inception, WAC has remained an estimated 2% higher than ASP. AWP has trended around 18% higher than both WAC and ASP.

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BARHEMSYS – Cost

BARHEMSYS, an ACACIA PHARMA, INC. product, became effective on January 1, 2024 and is aligned to J Code: J0184. There are two NDCs aligned to J0184. During the first quarter of 2024, WAC and ASP remained unchanged while still holding significantly higher than ASP.

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LAMZEDE – Cost

LAMZEDE’s HCPCS J0217, became effective on January 1, 2024. LAMZEDE has two NDCs aligned to J Code: J0217 with one potential error found within these mappings. From its early inception, both WAC and AWP have remained constant and unchanged.

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ARTESUNATE – Cost

ARTESUNATE is manufactured by AMIVAS (US), LLC, and is aligned to HCPCS J0391. ARTESUNATE’s HCPCS became effective on January 1, 2024. Beginning in January and continuing through the first quarter, AWP trended around 15% higher than WAC.

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DAXXIFY – Cost

DAXXIFY is manufactured by Revance Therapeutics, Inc. and is associated with HCPCS J0589. DAXXIFY became effective on April 1, 2024. From its inception, AWP has been an estimated 15% above WAC.

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IGALMI – Cost

IGALMI’s HCPCS J1105, became effective on January 1, 2024. IGALMI has two NDCs associated with the J Code, J1105, with no errors found within these alignments. Over the course of Q1, WAC and AWP have been unchanged with AWP remaining nearly 20% higher than WAC.

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POMBILITI – Cost

POMBILITI, a product of Amicus Therapeutics, became effective on April 1, 2024. POMBILITI is aligned to J Code: J1203. Early pricing indicates WAC being an estimated 20% below AWP.

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ELREXFIO – Cost

ELREXFIO’s `HCPCS J1323, became effective on April 1, 2024. There are currently two NDCs aligned to J Code: J1323. Pricing between ASP and WAC has remained close indicating little to no discount.

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ROCTAVIAN – Cost

ROCTAVIAN, became effective on January 1, 2024, and is aligned to J Code: J1412. Pricing between WAC and AWP has remained constant since introduction. WAC has trended over 15% below AWP.

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ELEVIDYS – Cost

ELEVIDYS, manufactured by Sarepta Therapeutics, became effective on January 1, 2024. ELEVIDYS is aligned to J Code: J1413 and has 61 NDCs with multiple discrepancies found within these mappings.

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