Important Price Change Announcement for Photrexa® – 9/28/23

 This email is being sent by BuyandBill.com on behalf of Glaukos®, Inc.

Announcing New Pricing for Photrexa® Cross-Linking Kit

As of October 1, 2023

Item

Code/Price

Description

HCPCS Code

J2787

Riboflavin 5′-phosphate, ophthalmic solution, up to 3 ml

NDC Number

25357-0025-03

A cross linking kit contains one Photrexa Viscous 3 ml single-patient use syringe and one Photrexa solution 3 ml single-patient use syringe, each in an individual foil pouch

New WAC Pricing*

$4,150 per kit

*Wholesale Acquisition Cost listed in Redbook effective 10/1/23

New WAC Pricing*

$2,075 per HCPCS Unit

*Wholesale Acquisition Cost listed in Redbook effective 10/1/23

We are respectfully requesting that you update your claims processing system, and fee schedules for PHOTREXA for all claims on or after October 1, 2023

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IMPORTANT SAFETY INFORMATION

INDICATIONS

Photrexa® Viscous (riboflavin 5′-phosphate in 20% dextran ophthalmic solution) and Photrexa® (riboflavin 5′-phosphate ophthalmic solution) are indicated for use with the KXL System in corneal collagen cross-linking (CXL) for the treatment of progressive keratoconus and corneal ectasia following refractive surgery.

 

LIMITATIONS OF USE

The safety and effectiveness of CXL has not been established in pregnant women, women who are breastfeeding, patients who are less than 14 years of age and patients 65 years of age or older.  Photrexa Viscous and Photrexa should be used with the KXL System only.

WARNINGS AND PRECAUTIONS

Ulcerative keratitis can occur. Patients should be monitored for resolution of epithelial defects.

ADVERSE REACTIONS

In progressive keratoconus patients, the most common ocular adverse reactions in any CXL treated eye were corneal opacity (haze), punctate keratitis, corneal striae, corneal epithelium defect, eye pain, reduced visual acuity, and blurred vision. In corneal ectasia patients, the most common ocular adverse reactions were corneal opacity (haze), corneal epithelium defect, corneal striae, dry eye, eye pain, punctate keratitis, photophobia, reduced visual acuity, and blurred vision.

These are not all of the side effects of Photrexa® Viscous, Photrexa® and the CXL treatment. For more information, see Prescribing Information.

You may report an adverse event to Avedro by calling 1-844-528-3376, Option 1 or you may contact the U.S. Food and Drug Administration (FDA) directly at 1-800-FDA-1088.

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Photrexa® is a registered trademark of Glaukos®, Inc.

October 2023