Myobloc and insurance


Posted by Nancy Knudsen , Feb 22,2002,15:33   Archive
I am getting injections next week and would like to try Myobloc because the Botox isn't working as well anymore. My doctor called mu insurance company and they would not give pre-autorization. We have Blue-Cross of California. I live in Florida. Has anyone had their insurance cover Myobloc injections. Any suggestions on how to get them to pay.





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Re: Myobloc and insurance

Re : Myobloc and insurance --- Nancy Knudsen
Posted by Anthiem (Dee in OR,Anthiem), Feb 22,2002,15:56 Top of Thread Archive
Nancy,

Here is an article that might help you.

Good luck.
A

Below you find a press release from Elan Corporation on billing codes for MYOBLOC. This new code should assist with reimbursement issues:

ELAN ANNOUNCES NEW MYOBLOC BILLING CODE

-- Benefits include electronic processing and faster processing time --


DUBLIN, IRELAND, January 11, 2002 -- Elan Corporation, plc (NYSE: ELN) ("Elan") announced today that MYOBLOC (Botulinum Toxin Type B) Injectable Solution has been assigned a unique Healthcare Current Procedural Coding System ("HCPCS") code effective January 1, 2002: J0587, Botulinum Toxin Type B,per 100 units, for intra-muscular administration. This unique code is a significant milestone for MYOBLOC and symbolizes its acceptance for cervical dystonia by the managed care community. Use of the new HCPCS code for MYOBLOC should allow for easier billing through electronic processing of claims, which generally results in a faster turn-around from filing to payment.

Elan's GO-1-CALL Customer Support Center is prepared to support physician use of the new HCPCS code. For physicians treating Medicare and Medicaid patients, Elan's reimbursement consultants provide the physician with current coverage policies. For physicians treating privately insured patients, consultants can perform an insurance verification that will verify a specific patient's benefits and determine which diagnosis codes the payer will cover. Elan's GO-1-CALL Customer Support Center can be reached at 1-888-GO-1-CALL (1-888-461-2255).

"Our customers are our number one focus and we want to provide the dystonia community with the best possible treatment and support system," said Mamie Sharpe, Director of Client Services at Elan. "We developed a comprehensive customer support system and secured a new specific billing code that facilitates electronic approvals and complements MYOBLOC's efficacy and ease of use."

MYOBLOC is the only FDA-approved botulinum toxin therapy provided in a ready-to-use solution and has been successfully used by physicians nationwide in reducing the severity of abnormal head position and neck pain associated with cervical dystonia. Botulinum Toxin Type B (MYOBLOC) is an antigenically distinct serotype from botulinum toxin type A and works by preventing the release of acetylcholine from the nerve ending to the overactive muscle. MYOBLOC is available in three convenient vial configurations of 2,500 units, 5,000 units and 10,000 units, all at the same concentration providing maximum flexibility for dosing.

Botulinum toxin should be used with caution in patients with peripheral motor neuropathic diseases (e.g., amyotrophic lateral sclerosis, motor neuropathy) or neuromuscular junctional disorders (e.g., myasthenia gravis or Lambert- Eaton syndrome) because of increased risk of severe dysphagia and respiratory compromise from typical doses. Co-administration of aminoglycosides or other agents that interfere with neuromuscular transmission should be done with caution as the toxin effects may be potentiated.

In clinical trials (n=5 70), severe dysphagia (3%, none required medical intervention) and severe dry mouth (6%) were reported. The most frequently reported adverse events at the 10,000 unit dose were dry mouth (34%), dysphagia (25%), injection site pain (15%), and dyspepsia (10%). These adverse events were generally mild to moderate, temporary, self-resolving, and more common with higher doses.

Elan Corporation, plc is a leading worldwide, fully integrated biopharmaceutical company headquartered in Ireland, with its principal research, development, manufacturing and marketing facilities located in Ireland, the United States and the United Kingdom. Elan is focused on the marketing of therapeutic products and services in neurology, pain management, oncology, infectious disease and dermatology and on the development and commercialization of products using its extensive range of proprietary drug delivery technologies. Elan shares trade on the New York, London and Dublin Stock Exchanges. For copies of press releases and additional information about the company, please consult Elan's homepage on the worldwide web at http://www.elan.com.




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Re: Myobloc and insurance

Re : Re: Myobloc and insurance --- Anthiem
Posted by Lynn Yarbrough , Feb 23,2002,12:52 Top of Thread Archive
>MYOBLOC is available in three convenient vial configurations of 2,500 units, 5,000 units and 10,000 units, all at the same concentration providing maximum flexibility for dosing.<

Note that the (mouse-)units used for MYOBLOC are not the same as for BOTOX. The MYOBLOC units work out to be roughly 100x the Botox units, so it's still about 1 vial per dose. It's just that type B is a much better mouse-killer than type A.

--- Lynn




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