Boehringer Ingelheim announced today the U.S. Centers for Medicare & Medicaid Services (CMS) has issued a permanent J-code (J1747) for SPEVIGO (spesolimab-sbzo) Injection, indicated for the treatment of generalized pustular psoriasis (GPP) flares in adults. According to the Healthcare Common Procedure Coding System (HCPCS), the J-code for SPEVIGO becomes effective as of today, April 1, 2023.
"People living with GPP can experience unpredictable flares and are in need of timely access to novel treatment options," said Claudia Beqaj, Executive Director, Dermatology, Sales and Marketing, Boehringer Ingelheim. "We are pleased to receive the permanent J-code for SPEVIGO that aims to enhance and expand market access for those affected by this rare and potentially life-threatening neutrophilic skin disease."
J-codes are permanent, product-specific reimbursement codes used by commercial insurers and government payers to facilitate and streamline billing for Medicare Part B drugs, which cannot be self-administered.
The permanent J-code for SPEVIGO, J1747 (Injection, spesolimab-sbzo, 1 mg), has been published online in the CMS HCPCS Application Summaries and Coding Recommendations, Fourth Quarter, 2022 HCPCS Coding Cycle, here.
What is SPEVIGO?
SPEVIGO is a prescription medicine used to treat generalized pustular psoriasis (GPP) flares in adults. It is not known if SPEVIGO is safe and effective in children.
Allergic reactions and infusion-related reactions. Serious allergic reactions may happen during or after your infusion of SPEVIGO. If you have a serious allergic reaction, your healthcare provider will stop treatment with SPEVIGO. If you have an infusion-related reaction, your healthcare provider will stop your SPEVIGO infusion and treat your symptoms and may restart SPEVIGO at a slower infusion rate. Tell your healthcare provider or get emergency medical help right away if you get any of the following symptoms during or after your infusion of SPEVIGO:
About generalized pustular psoriasis (GPP)
GPP is a rare, heterogenous and potentially life-threatening neutrophilic skin disease, which is clinically distinct from plaque psoriasis. GPP is caused by neutrophils (a type of white blood cell) accumulating in the skin, resulting in painful, sterile pustules all over the body. The clinical course varies, with some patients having a relapsing disease with recurrent flares, and others having a persistent disease with intermittent flares. While the severity of GPP flares can vary, if left untreated they can be life-threatening due to complications such as sepsis and multisystem organ failure. This chronic, systemic disease has a substantial quality of life impact for patients and increased healthcare burden. GPP has a varied prevalence across different geographical regions and more women are affected than men.
GPP flares can lead to hospitalization with serious complications, including heart failure, renal failure and sepsis, and the unpredictability and severity of these flares greatly affect a person's quality of life.
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