🤬🤬🤬✖️ The Excessive Reimbursement of Remicade is 3x worse in the BCBS MRF data than what we saw last week in UHC and Aetna.

CEOs and CFOs, are you furious yet? If you don't push back on your health plan there's no opposition to this absurdity.

For example, at 500mg Medicare's rate is $1,743 vs $62,221 shown in the BCBSIL MRF data. Although it's not reflected in every BCBS Plan, the data is showing negotiated rates for Remicade at more than 3,000% Medicare. In the Aetna and UHC analysis, the max reimbursement was approximately 1,000% Medicare: https://lnkd.in/ek73g_Ws

Data Geek Notes: 👉275 BCBS MRF files were queried using the ijson library in python (1.1TB of data in total) 👉💻 Previously ran for approx 26 hours on i7-11th Gen with 16GB ram 👉🖥️💡New Desktop ran code in approx 3 hours on i9-13th Gen with 128 GB ram 👉Chart produced in tableau desktop 👉Slide created in PowerPoint and exported as pdf

Analysis & MRF Notes: 👉Health Plan Rates: March 2023 HP MRF In Network files 👉Included fee for service, excluded bundled rates 👉CMS Rates is Based on January 2023 ASP for Remicade (J1745) 👉500mg is Remicade's on label dosing for a 100KG patient (5mg/kg) with Crohn's. 👉Since each unit of J1745 (Remicade) represents 10mg the rate was multiplied by 50 to get the cost of a 500mg infusion

BCBS_Remicade(2023-05-18).pdf

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