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Friday, August 3, 2018

La Jolla to Get New Technology Add-on Payment Coverage for Septic Shock Med


La Jolla Pharmaceutical Company (Nasdaq: LJPC), a leader in the discovery, development and commercialization of innovative therapies intended to significantly improve outcomes in patients suffering from life-threatening diseases, today announced that the Centers for Medicare & Medicaid Services (CMS) has granted a New Technology Add-on Payment (NTAP) for GIAPREZATM (angiotensin II) Injection for Intravenous Infusion. GIAPREZA is indicated to increase blood pressure in adults with septic or other distributive shock.
The CMS NTAP program provides additional reimbursement to hospitals beyond the Medicare Severity Diagnosis-Related Group (MS-DRG) reimbursement for specific products that meet strict criteria for the treatment of Medicare patients. The amount of the NTAP is equal to 50% of the amount by which the covered costs exceed the MS-DRG reimbursement, or 50% of the cost of the drug, whichever is less. The NTAP for GIAPREZA is effective for the CMS 2019 fiscal year, which begins on October 1, 2018, and is expected to continue for a period of up to two or three years, after which the MS-DRG payments will be adjusted based on hospital-reported costs and utilization. The NTAP program is only available to new drugs that represent an advance in medical technology that substantially improves, relative to technologies previously available, the treatment of Medicare patients.
In the final rule concerning Hospital Inpatient Prospective Payment Systems and Fiscal Year 2019, CMS states that: “Based on the data provided by the applicant and consideration of the public comments we received, we agree with the applicant and the commenters that GIAPREZA™ represents a substantial clinical improvement over existing technologies because it quickly and effectively raises MAP while allowing for a reduction in other vasopressors.”
“The receipt of NTAP coverage for GIAPREZA reaffirms the need for innovative treatment options for patients with septic shock and recognizes GIAPREZA’s potential as a significant medical advancement,” said George F. Tidmarsh, M.D., Ph.D., President and Chief Executive Officer of La Jolla.

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