Aralast NP - CuraFi

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Aralast NP (A1-PI)

Billing

Code: J0256

Description: Alpha 1 proteinase inhibitor

Unit: 10 mg

Payment: $4.806

Pay quarter: Q4 2023

Dosage and Frequency

Alpha-1 Antitrypsin Deficiency

• 60mg/kg IV every 1 week

Calculate drug reimbursement

Patient dosage

Patient insurance

Total Reimbursement:

$2,306.88

(ASP: $2,176.30, Margin: $130.58)

Code:

J0256

# Units to bill:

480

Prior Authorization

Prior auth criteria for Aralast NP may include but is not limited to:

1. The patient must be 18 years of age or older.
2. The patient must have a diagnosis of alpha-1 antitrypsin deficiency (AATD).
3. The patient must have a serum AAT level of ?11 micromoles/L (or equivalent) as confirmed by a laboratory test within the past 12 months.
4. The patient must have a body mass index (BMI) of ?18.5 kg/m2 or greater.
5. The patient must have an FEV1 of ?80% predicted or an FEV1/FVC ratio of ?0.7.
6. If the patient is a smoker, they must be enrolled in an approved smoking cessation program.
7. The patient must not have had any prior adverse reactions to Aralast NP.
8. The patient must not have any other contraindications to using Aralast NP.

Insurance prior auth guidelines:

Billable NDCs

00053-7201-02

Zemaira (CSL BEHRING LLC)

1 MG

00944-2814-01

Aralast NP (TAKEDA PHARMACEUTICALS AMERICA, INC.)

1 MG