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Sunday, May 12, 2024 5:51:29 PM
On a separate note, It will be interesting to check J0589 code reimbursement amount which usually has a 3 month lag. But always good insight. Especially with the neurotoxins with data. If you can gain knowledge on cost, then you can assess how close they are to reimbursement levels. This applies more to therapeutics than aesthetic (as discounting on volume is more prevalent there). Yes, there are agreements in place in therapetics as well, but the j code reimbursement does provide nice general insight. Especially if you can see that it is underwater. Lastly, for therapeutics cost does matter to the smaller practices as they wait for reimbursement which can take 90 days or more. So if Daxi comes in at a lower price per unit then it can be sold to smaller practices as less financial outlay up front. Here is the site.
https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files
So for Dysport - J0586 you see that they get reimbursed 8.682 per 5 units. Which means that they get reimbursed for a 500 unit vial 868.20
For Botox - J0585 they get reimbursed 6.319 per unit or 631.9 for 100 unit vial.
Typically people look at a ratio of 2.5 to 1 for Dysport to Botox that means that you need 200 units of botox for 500 units of Dysport. So lets say that botox costs 625$ per unit to practice per 100 unit vial and Dysport costs 825$ You can do a little math and see how much initial financial outlay is to buy on a apples to apples comparison using the ration for Dysport it would be 825 for Botox it would be 1250. Now what will Daxi be? That could be interesting. For CD initial treatment is typically 100 units of botox or 250 Dysport
You can also compare cost to reimbursement assuming no discounting. Provides some insight
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