Program and Eligibility. If you meet the eligibility criteria, you can get help with your OCREVUS drug costs, infusion costs or both. This program helps with the cost of OCREVUS only. It does not help with the cost of other medicines you take at the same time as OCREVUS . J Injection, tetracycline, up to mg J Injection, omadacycline, 1 mg New J Injection, eravacycline, 1 mg New J Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered). Ocrevus (ocrelizumab) may not be approved for the I. All other indications not included above; OR II. Individual has active hepatitis B or hepatitis C virus infection or another active infection at initiation of therapy; OR III. Individual has a history of infusion reaction to Ocrevus . VI. Code/Availability Information Jcode: • J - Injection, ocrelizumab, 1 mg; 1 mg = 1 billable unit NDC: • Ocrevus mg/10 mL vial: xx VII. References 1. Ocrevus [package Insert]. South San Francisco, CA; Genentech, Inc.; July August 2. A J code may cover the supply, injection or infusion of a drug or biological. J codes typically includes drugs that cannot self-administered, are reasonable and necessary for the treatment of the injury or illness and considered effective by the FDA, among other requirements. Ocrevus (ocrelizumab) injection is a preservative-free, sterile, clear or slightly opalescent, and colorless to pale brown solution supplied as a carton one mg/10 mL (30 mg/mL) vial (NDC ). Store Ocrevus vials at 2°C–8°C (36°F–46°F) in the outer carton to protect from light. Do not freeze or shake. Ocrevus is unproven and not medically necessary for the treatment of: of a code in this policy does not imply that the service described by the code is a covered or non- UnitedHealthcare Commercial Medical Benefit Drug Policy Effective 08/01/ HIGHLIGHTS OF INFORMATION These highlights do not include all the information needed to use OCREVUS safely and effectively. See full information for OCREVUS. OCREVUS® (ocrelizumab) injection, for intravenous use Initial U.S. Approval: RECENT MAJOR CHANGES MEDICATION GUIDE OCREVUS® (oak-rev-us) (ocrelizumab) injection, for intravenous use What is the most important information I should know about OCREVUS? OCREVUS can cause serious side effects, o Infusion reactions: OCREVUS can cause infusion reactions that can be serious and require you to be hospitalized. of a code in this policy does not imply that the service described by the code is a covered or non- Ocrevus™ (Ocrelizumab) Page 4 of 6 UnitedHealthcare Oxford Clinical Policy Effective 06/01/
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OCREVUS Reimbursement | OCREVUS Access Solutions
Because Ocrevus (NDC ) is a biologic drug, its generic J-code will be J (Biologic drug, NOC). Payers will take a very close look at all claims that contain an NOC J-code, as many different drugs fall into this category at any given time. Here are some tips to guide Size: KB. OCREVUS Sample This information may assist you as you complete the payer forms for OCREVUS. These tables are provided for informational purposes only. Please visit lbjnq.linkpc.net or other payers’ websites to obtain additional guidance on their processes related to and for vials and wastage. J Injection, tetracycline, up to mg J Injection, omadacycline, 1 mg New J Injection, eravacycline, 1 mg New J Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered).