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Medicare Costs For Johnson & Johnson's Psoriasis Drug Stelara Double When Obtained at Pharmacies
Medicare and its beneficiaries are paying significantly more for Stelara, Johnson & Johnson’s (NYSE:JNJ) popular biologic drug used to treat autoimmune diseases when obtained through pharmacies rather than administered in physician offices.
Stelara is approved for treating psoriasis, psoriatic arthritis, Crohn’s disease, and ulcerative colitis.
According to a recent analysis by the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS), this price discrepancy is primarily due to differing payment determination methods.
Subcutaneous (under-the-skin) versions of Stelara are typically self-injected and covered under Medicare Part D.
Before 2023, Part B also covered subcutaneous versions of Stelara when a physician administered the injection; however, Medicare Administrative Contractors (MACs) now exclude Stelara injections under a policy designed to omit self-administered drugs from Part B coverage.
Medicare and its enrollees incurred ...