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Chargeback for MabThera 3 months after Orencia
by Eui Kyoung Yoon (ekyeun@dreamdrug.com)
Published : Dec 2, 2014 10:52:49
MabThera is not covered when it is used without clear evidence that Orencia doesn’t work for rheumatoid arthritis.

The Health Insurance Review and Assessment Service (HIRA) recently made a decision after reviewing the case of a 55 year-old woman with RA.

The patient had used Humira for one year to treat RA, and then started Orencia after the swelling of joints was found. Three months later, MabThera was used for her.

HIRA said the evaluation should have been made six months after Orencia was started and charged the cost back to the healthcare provider.

It explained that it was not appropriate to change Orencia to Mabthera without any effort to optimize the previous therapy.
 
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