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Analysis of the American Rheumatology Network-Trio Health (ARN-Trio) registry finds a surge in new prescriptions for Merck’s Renflexis infliximab biosimilar. The ARN-Trio registry is the first rheumatology registry to combine pharmacy dispensing data with electronic medical records (EMR) to provide unparalleled real-world insights. ARN-Trio is the largest registry of biosimilar use in community rheumatology practice, and data from 5 large practices chosen for geographic variety reveal insightful trends in infliximab biosimilar use. Initially, the use of Pfizer’s Inflectra (infliximab-dyyb) followed by Merck’s Reflexis (infliximab abda) followed trajectories largely explained by the well-documented formulary restrictions and time to market challenges inherent

Analysis of the American Rheumatology Network-Trio Health (ARN-Trio) registry finds that AbbVie’s Rinvoq use is increasing rapidly as a proportion of JAK inhibitor use. Rheumatologists are asking, why is use of AbbVie’s Rinvoq increasing so rapidly? Given the higher cost of Rinvoq (annual net price $44,035) and similar safety and efficacy across the JAK inhibitor class, the evidence suggests that Rinvoq adoption is driven by formulary exclusions.[i] Formulary exclusions are powerful tools used by pharmacy benefit managers (PBMs) to negotiate deeper rebates from manufacturers. Manufacturers who do not offer satisfactory rebates face exclusion from the PBM’s national formulary. Unfortunately for

American Rheumatology Network (ARN) and Trio Health (Trio) have launched the first rheumatology registry that combines pharmacy dispensing data with electronic medical records (EMR) to provide unparalleled real-world insights into patient experiences and outcomes. The new database includes over 75,000 patients within the ARN’s national network, serving as a comprehensive data solution that combines EMR, infusion, and pharmacy information. This allows for improved coordination of patient care, longitudinal care tracking, identification of care trends and access disparities. The ARN-Trio registry is unique among rheumatology registries in capturing real-time, patient-level data from the time of prescription to pharmacy dispensation or in-office

The American Rheumatology Network (ARN) has been so successful with cost management, particularly via the use of biosimilars, that it believes its model is worthy of emulation, said Colin C. Edgerton, MD, executive chairman of ARN, who spoke on the subject recently in an Academy of Managed Care Pharmacy–sponsored webinar. “Certainly, rheumatologists are eager to see price reductions, which will lead to increased patient access to these critical medications for our patient population,” Edgerton said. Edgerton practices with Low Country Rheumatology, a private practice in Charleston, South Carolina. The group used a pathway for treatment, employing biosimilars, that significantly lowered

by Colin Edgerton We are seeing COVID-19 cases peak in many areas of the US, prompting thoughts about what comes next for rheumatology practices. Many community rheumatology practices have been hit hard by the crisis, and we hope that sharing “lessons learned” will inform practices on what steps to take now, and what to anticipate soon. Articularis Health Group (AHG) is the largest rheumatology practice in the country, with practice sites throughout the states of South Carolina, Georgia, Florida, and Tennessee. AHG’s 55 providers (41 rheumatologists and 14 APCs) practice together with clinical and financial integration. AHG also participates in

As of 12:30pm ET on March 17, 2020 CMS has sent out an official notification stating that effective for services starting March 6, 2020 (retroactive), the limitations on where Medicare patients are eligible for telehealth services has been removed during the emergency. The waiver temporarily eliminates the requirement that the originating site must be a physician’s office or other authorized healthcare facility and allows Medicare to pay for telehealth services when beneficiaries are in their homes or any setting of care. CMS will temporarily pay clinicians for certain telehealth services. Each type of service is defined by conditions and reimbursement

Updated March 17, 2020 3:00pm American Rheumatology Network (ARN) members are concerned about safe access to care during the COVID-19 pandemic. The Centers for Disease Control and Prevention (CDC) has recommended use of telehealth, when clinically appropriate, to lessen the risk of disease transmission. CDC recommendations are fluid and rapidly changing, and rheumatologists and rheumatology professionals are encouraged to check these frequently: https://www.cdc.gov/coronavirus/2019-nCoV/index.html. Many rheumatologists and rheumatology health professionals have little experience with telehealth, and this guide is designed to offer an overview. Specific information regarding reimbursement varies from state to state and between insurance providers. Therefore, this guide does

Originally published in The Rheumatologist The Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule final rule for 2020 includes a big win for rheumatologists—a 15% increase in reimbursement for evaluation and management (E/M) services. This decision represents an historic hike in payment for these codes and resulted from 10 years of advocacy work by the ACR and other cognitive care specialists. The change is set to take effect in January 2021 and is based on revised E/M code definitions developed by the American Medical Association (AMA) CPT Editorial Panel and RUC-recommended values for these services. It will replace

Charleston, SC, Feb. 18, 2020 – American Rheumatology Network (ARN) announces their partnership with Framework Management Information, Inc. (Framework) to develop AXCESS1, a new prescription access hub. AXCESS1 seamlessly interfaces with healthcare practices, specialty pharmacies, and pharmaceutical manufacturers serving as a “one-stop shop” for information pertaining to prior authorization status, patient assistance programs, and medication dispensing. AXCESS1 solves the problem of fragmentation as it functions with every involved pharmacy, manufacturer, and payer system. “AXCESS1 will provide progress updates for all parties involved in the prescription process through a dashboard updated in real-time,” explains Danielle Lydon, CEO of Framework. Positive Impacts