CMS approves NTAP for fidaxomicin

September 13, 2012

A new technology add-on payment for Dificid (fidaxomicin) for Clostridium difficile-associated diarrhea was recently approved by the Centers for Medicare and Medicaid Services.

A new technology add-on payment (NTAP) for Dificid (fidaxomicin) for Clostridium difficile-associated diarrhea (CDAD) was recently approved by the Centers for Medicare and Medicaid Services (CMS).

The CMS approval was part of the agency’s Final Rule on Medicare, Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment Systems.

The NTAP payment will provide hospitals with a payment for Dificid tablets administered in an inpatient setting, in addition to the standard-of-case DRG reimbursement of up to 50% of the cost of the tablets. The reimbursement will be effective in the fiscal year starting October 1, 2012, and CMS has assigned a maximum payment of $868 for 2013.

“After reviewing the totality of the evidence and the public comments we received, we agree with the commenters that Dificid represents a treatment option with the potential to decrease hospitalizations and physician office visits, and reduce the recurrence of CDAD,” according to the CMS statement in the Final Rule.

The reimbursement will help hospitals defray the costs of using the tablets, according to Pedro Lichtinger, president and CEO of Dificid’s manufacturer, Optimer Pharmaceuticals in San Diego. “The aggregate costs for all C. difficile infections in the U.S. exceeds $8 billion,” Lichtinger said.