Since 1997, over 20,000 procedures have been performed with GLIADEL.4
Coding and Reimbursement
Medicare has recognized the clinical value of chemotherapeutic implant treatment
and the importance of maintaining patients' access to inpatient therapy. Be sure
to ask about the reimbursement status of GLIADEL® Wafer or call the
toll free hotline listed below for immediate questions.
MGI PHARMA Access Program (MAP)
The MGI PHARMA Access Program (MAP) has been developed to assist with information
regarding the reimbursement processes associated with precertification (prior
authorization), coverage, coding, and payment for GLIADEL.
MAP Toll-Free Hotline
The MAP Program is accessible free of charge to anyone with questions about insurance
coverage and reimbursement for GLIADEL and related procedures.
Contact the MGI PHARMA Access (MAP) Program
Phone: 1-877-644-6270
Fax: 1-888-644-7236
9:00 A.M. - 8:00 P.M. EST
Monday through Friday
How can the MAP Program help you?
We encourage you to contact the hotline prior to surgery so they can perform appropriate
insurance research and help coordinate access to GLIADEL.
How can MAP help you?
With just one call, you will reach a MAP representative who will be pleased to assist
you. We encourage you or your neurosurgeon to contact the hotline prior to surgery
so that we can perform appropriate insurance research and help coordinate access
to GLIADEL.
Billing and claims coding assistance
The MAP Program representatives can help identify the appropriate billing codes,
compile the necessary documentation to submit claims for GLIADEL and associated
procedures correctly, and assist with claims submissions.
Insurance verification
MAP Program representatives can help contact insurance companies on behalf of surgeons
and hospitals to determine how GLIADEL will be reimbursed.
Prior authorization support
MAP Program representatives can facilitate the prior authorization process by determining
individual insurer requirements, coordinating paperwork, and following up with payers
for coverage and payment determination.
Coverage appeals
MAP Program representatives’ review denied or underpaid claims, explain appeal procedures,
make suggestions for resubmissions, and follow up throughout the appeal process.
Policy monitoring
MAP Program representatives monitor public and private coverage policies. They are
available to answer general questions you have about insurance coverage and reimbursement
for GLIADEL. Patient Assistance.
The GLIADEL Patient Assistance Program provides free replacement product to hospitals
for patients that meet the eligibility criteria. The program is open to patients
who have no insurance, either public or private, and cannot afford to pay for GLIADEL.
Eligible patients must meet income guidelines. Further, the Patient Assistance Program
provides replacement product only to institutions that have already purchased GLIADEL.
Please note that the Patient Assistance Program complies with all HIPAA privacy
standards in order to protect the privacy of personal health information.
The MAP Program oversees the initial screening and administration of the GLIADEL
Patient Assistance Program. For more information about the program, or for eligibility
and enrollment criteria, please contact the MAP Program directly.
Contact the MGI PHARMA Access (MAP) Program
Phone: 1-877-644-6270
Fax: 1-888-644-7236
9:00 A.M. - 8:00 P.M. EST
Monday through Friday
Visit this page to find specific coding information:
References
Prescribing Information
Important Safety Information
Indications:
GLIADEL® Wafer is indicated in patients with newly diagnosed high-grade
malignant glioma as an adjunct to surgery and radiation. GLIADEL is also indicated
in patients with recurrent glioblastoma multiforme as an adjunct to surgery.
Contraindication:
GLIADEL® Wafer should not be given to patients who have demonstrated
a previous hypersensitivity to carmustine or any of the components of GLIADEL.
Warnings:
Patients undergoing craniotomy for malignant glioma and implantation of GLIADEL
should be monitored closely for known complications of craniotomy, including seizures,
intracranial infections, abnormal wound healing, and brain edema.
Cases of intracerebral mass effect unresponsive to corticosteroids have been described
in patients treated with GLIADEL, including one case leading to brain herniation.
Precautions:
Communication between the surgical resection cavity and the ventricular system should
be avoided to prevent the wafers from migrating into the ventricular system and
causing obstructive hydrocephalus. If a communication larger than the diameter of
a wafer exists, it should be closed prior to wafer implantation.
Computed tomography and magnetic resonance imaging of the head may demonstrate enhancement
in the brain tissue surrounding the resection cavity after implantation of GLIADEL.
This enhancement may represent edema and inflammation caused by GLIADEL or tumor
progression.
The short-term and long-term toxicity profiles of GLIADEL when given in conjunction
with chemotherapy have not been fully explored.
Pregnancy and Nursing:
There are no studies assessing the reproductive toxicity of GLIADEL. Carmustine,
the active component of GLIADEL, can cause fetal harm when administered to a pregnant
woman.
It is recommended that patients receiving GLIADEL discontinue nursing.
Adverse Events:
Seizures:
In the initial surgery trial, the incidence of seizures was 33.3% in patients receiving
GLIADEL and 37.5% in patients receiving placebo. Grand mal seizures occurred in
5% of GLIADEL-treated patients and 4.2% of placebo-treated patients. The incidence
of seizures within the first 5 days after wafer implantation was 2.5% in the GLIADEL
group and 4.2% in the placebo group.
In the surgery for recurrent disease trial, the incidence of post-operative seizures
was 19% in both patients receiving GLIADEL and placebo. In this study, 12/22 (54%)
of patients treated with GLIADEL and 2/22 (9%) of placebo patients experienced the
first new or worsened seizure within the first five post-operative days. The median
time to onset of the first new or worsened post-operative seizure was 3.5 days in
patients treated with GLIADEL and 61 days in placebo patients.
Brain Edema:
In the initial surgery trial, brain edema was noted in 22.5% of patients treated
with GLIADEL and in 19.2% of patients treated with placebo. Development of brain
edema with mass effect (due to tumor recurrences, intracranial infection, or necrosis)
may necessitate re-operation and, in some cases, removal of GLIADEL or its remnants.
Healing Abnormalities:
The following healing abnormalities have been reported in clinical trials of GLIADEL:
wound dehiscence, delayed wound healing, subdural, subgaleal or wound effusions,
and cerebrospinal fluid leak. In the initial surgery trial, healing abnormalities
occurred in 15.8% of GLIADEL-treated patients and in 11.7% of placebo recipients.
Cerebrospinal fluid leaks occurred in 5% of GLIADEL recipients and 0.8% of those
given placebo. During surgery, a water-tight dural closure should be obtained to
minimize the risk of cerebrospinal fluid leak.
In the surgery for recurrent disease trial, the incidence of healing abnormalities
was the 14% of GLIADEL treated patients and 5% in patients receiving placebo wafers.
Intracranial Infection:
In the initial surgery trial, the incidence of brain abscess or meningitis was 5%
in patients treated with GLIADEL and 6% in patients receiving placebo. In the recurrent
setting, the incidence of brain abscess or meningitis was 4% in patients treated
with GLIADEL and 1% in patients receiving placebo.
Please see the Prescribing Information for more information.
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