Zemaira - CuraFi

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Zemaira (A1-PI)

Billing

Code: J0256

Description: Alpha 1 proteinase inhibitor

Unit: 10 mg

Payment: $4.806

Pay quarter: Q4 2023

Dosage and Frequency

A1-PI 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 Zemaira 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 (AAT) deficiency established by a blood test.
3. The patient must not have any contraindications to the use of Zemaira, such as active hepatic disease, hypersensitivity to the product or its components, or a history of anaphylaxis or other severe allergic reaction.
4. The patient must have failed standard therapy, including lifestyle modifications and/or other treatments.
5. The patient must have adequate respiratory function as demonstrated by an FEV1 of less than 75% of the predicted normal value for age, height, and sex.
6. The patient must be willing to comply with the long-term follow-up requirements and adhere to the medication regimen.
7. The patient must not have any other medical condition that would interfere with the effectiveness or safety of Zemaira therapy.

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