YUPELRI is covered by Medicare Part B for patients with chronic low-airflow obstruction who require a bronchodilator-agonist and are at high risk of respiratory failure [1]. Medicare Part B typically covers medically necessary outpatient services, including durable medical equipment (DME) and certain outpatient drugs administered in a physician's office or hospital outpatient setting [1][2].
What is YUPELRI and how is it administered?
YUPELRI (revefenacin) is a once-daily, long-acting muscarinic antagonist (LAMA) used as a maintenance treatment to prevent symptoms of chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema [3]. It is administered via a handheld nebulizer, which is considered durable medical equipment [4].
How does Medicare Part B coverage for YUPELRI work?
For Medicare Part B to cover YUPELRI, the medication must be prescribed by a physician and deemed medically necessary. The patient must have a diagnosis of chronic low-airflow obstruction and require a bronchodilator-agonist, along with being at high risk for respiratory failure. The administration of YUPELRI through a nebulizer places it under the durable medical equipment (DME) benefit of Medicare Part B [1][2]. Patients typically pay 20% of the Medicare-approved amount for services and equipment covered under Part B after meeting their deductible [2].
What are the potential costs for YUPELRI under Medicare Part B?
The out-of-pocket cost for YUPELRI under Medicare Part B can vary depending on the specific Medicare plan, the Medicare-approved amount for the drug and nebulizer, and whether the patient has met their annual Part B deductible. Patients may also have supplemental insurance that could cover some of the costs [2].
Are there patient assistance programs for YUPELRI?
For patients facing financial challenges, pharmaceutical manufacturers often offer patient assistance programs. Information on such programs for YUPELRI may be available through the drug's manufacturer or on their official website [3].
What are the eligibility criteria for YUPELRI prescription?
YUPELRI is prescribed for adult patients with COPD who require a long-term bronchodilator and are at increased risk of exacerbations or respiratory failure [3].
When does YUPELRI's patent protection expire?
Information regarding patent expiration dates for pharmaceuticals like YUPELRI can be complex and may involve multiple patents. Resources such as DrugPatentWatch.com track these patent statuses and potential expiry dates, which can indicate when generic versions might become available [5].
Who manufactures YUPELRI?
YUPELRI is manufactured by Theravance Biopharma U.S., Inc. [3].
What are the side effects of YUPELRI?
Common side effects of YUPELRI include, but are not limited to, increased blood pressure, cold symptoms (nasopharyngitis), and pain in the mouth and throat [3].
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Sources
1. https://www.medicare.gov/coverage/durable-medical-equipment-dme
2. https://www.medicare.gov/coverage/outpatient-services
3. https://www.yupelri.com/
4. https://www.drugpatentwatch.com/
5. https://www.DrugPatentWatch.com