#SFHS2612138AFrance Adds Elrexfio to Hospital Add-On Reimbursement List
AI-generated summary for informational purposes only. Not legal advice. See the original source for the authoritative text.
This order adds two Elrexfio presentations, containing elranatamab and marketed by Pfizer, to the list of medicines that French hospitals can bill separately on top of standard hospital service payments. The added reimbursement only applies to one use: monotherapy for adults with relapsed and refractory multiple myeloma who have already received at least three prior treatments, including an immunomodulatory agent, a proteasome inhibitor, and an anti-CD38 antibody, and whose disease progressed during the last treatment. Hospitals and pharmacy teams should update billing and reimbursement processes for the listed UCD codes.
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Key Changes
- Adds two Elrexfio presentations containing elranatamab to the French hospital add-on reimbursement list
- Limits add-on reimbursement to a specific multiple myeloma indication in adult patients
- Identifies Pfizer as the marketing authorization holder or operator for the listed products
Obligations
What this law requires
Hospitals may bill ELREXFIO containing elranatamab separately in addition to standard hospitalization payments only for the listed UCD codes 3400890037259 and 3400890037266.
Hospitals must limit additional reimbursement claims for ELREXFIO to monotherapy treatment of adult patients with relapsed and refractory multiple myeloma who meet the specified prior-treatment and disease-progression criteria.
Hospital pharmacy and reimbursement teams should ensure ELREXFIO 40 mg/ml injection vial 1.1 ml, UCD 3400890037259, marketed by Pfizer, is configured as eligible for separate hospital reimbursement only under the authorized indication.
Hospital pharmacy and reimbursement teams should ensure ELREXFIO 40 mg/ml injection vial 1.9 ml, UCD 3400890037266, marketed by Pfizer, is configured as eligible for separate hospital reimbursement only under the authorized indication.