Drug IndexEylea (aflibercept)



Billing

Code: J0178

Description: Aflibercept injection

Unit: 1 MG

Payment: $862.280

Pay quarter: Q1 2024


Covered in Part D: No


Drug Cost

Calculate drug cost and reimbursement


Total WAC:

$1,850.00

Total Reimbursement:

$1,724.56

(ASP: $1,626.94, Margin: $97.62)

.

.

# Units to bill:

2

Dosage & Frequency

Neovascular (Wet) Age-Related Macular Degeneration (AMD)

Induction:
• 2mg IVT every 1 month for the first 3 months

Maintenance:
• 2mg IVT every 2 months

Macular Edema Following Retinal Vein Occlusion (RVO)

• 2mg IVT every 1 month

Diabetic Macular Edema (DME)
Diabetic Retinopathy (DR)

Induction:
• 2mg IVT every 1 month for the first 5 injections

Maintenance:
• 2mg IVT every 2 months


Billable NDCs

61755-0005-01

Eylea (REGENERON PHARMACEUTICALS INC.)

2 MG


61755-0005-02

EYLEA (REGENERON PHARMACEUTICALS INC.)

2 MG



Prior Authorization

Aetna

United Healthcare

Anthem

Cigna


Resources

Website