CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`EYLEA’ (aflibercept) Injection
`Components of Reimbursement
`
`inc. All rights reserved, US-E4U-1218 09/2015
`
`ation available fromthe representative in attendance
`Please seefull
`©2015, Regeneron Pharmaceuticals,
`
`GYEYLEA
`
`(aflibercept) Injection
`For Intravitreal Injection
`
`Exhibit 2218
`
`Page 01 of 24
`
`
`
`Mylan v. Regeneron
`IPR2021-00881
`U.S. Pat. 9,254,338
`Exhibit 2218
`
`

`

`CONFIDENTIAL MATERIAL- SUBJECT TO PROTECTIVE ORDER
`
`Building Blocks of Reimbursement
`
`intravitreal hwactor
`
`Reimbursement
`
`QVEYLEA
`laflibercept)Injection
`For
`
`Define what products or
`services are eligible for
`reimbursement
`
`identify specific products
`and services for claims
`submission
`
`Define reimbursement
`
`methodologies and
`amounts
`
`Exhibit 2218
`
`Page 02 of 24
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`

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`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`Medicare is the Predominant Payer for Patients with Wet AMD and
`Macular Edema Following RVO
`
`MacularEdemaFollowing
`RVO
`
`7%
`
`Medicaid
`<1%
`
`Inka
`
`i
`
`PayerMix
`
`Medicaid
`<1%
`
`For etraviveal Iyactor
`
` EYLEA® (affibercept) Injection is contraindicated in patients with ocular or periocular infections, active intraocular
`»
`inflammation, or known hypersensitivity to aflibercept or to any of the excipients in EYLEA.
`
`Medicare Advertage errofedmMA steveMA) percertage imreted bared on rebonal percentage (2%) of af Medcee teretowwe
`
`
`
`
`
`
`
`
`Meal
`Je
`
`Please see ful! Prescribing Information available from the representotive in ottendonce
`
`RYEYLEA
`
`Exhibit 2218
`
`Page 03 of 24
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`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`Private or Commercial Insuranceis the PredominantPayerfor Pa’
`Diabetic Macular Edema (DME), overall Medicare is the Predominant Payer
`for all FDA Approved Indications
`
`DiabeticMacularEdema(OME)AILEDAApprovedIndications
`
`
`
`for EYLEA
`
`taal
`Medicaid FFS
`~1%
`
`4
`
`Set Pay 6%
`
`Selt-Pay
`4%
`Medicad
`<1%
`
`Uninown
`<1%
`
`Please see full Prescribing information available from the representative in attendance
`
`Serious adverse reactions related to the injection procedure have occurred in <0.1% of intravitreal injections with
`EYLEA including endophthalmitis and retinal detachment.
`Verteee Atredtage (MA)penertageetewetter! mead orutteredpereertnge FR of at Meters tematesermnorndent9 UA peer ee ow(yetant fe
`
`
`MoccarePraga NethACkee 10%4Repent Avemabte af 1MeyeMeepsdinOkarateDeineamesbat|tetabomsertoecepor!ctWits!|Managed °
`Meticwdpercentage sotrates tuned on te raterat average (T%| form 20082010 Avante wt hz mee cir aoe™mneeth-StmenceDataSintere Commuter
`. EYLEA
`laaGouros Conance sraiyen of 2006-2010 The Haftonat Aunbutatory Medica! Cane Gurwey (MAMCG? data
`aflibercept) Injection
`
`Exhibit 2218
`
`Page 04 of 24
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`

`

`eereure is
`Preteteleul 8)
`
`Macular EdemaFollowing
`Retinal Vein Occlusion
`
`Diabetic Macular Edema (DME) /
`Diabetic Retinopathy in patiorts with DME*
`
`Medicare (Fee-for-Service)
`Covered and reimbursed byall Medicare administrative contractors
`
`Medicare Advantage
`Covered by Medicare Advantage plans; however, coverage guidelines, cost sharing, and benefit
`restrictions can differ from traditional Medicare
`
`Commercial Payers
`
`Covered by majority of commercial payers; however, coverage guidelines, cost sharing, and benefit
`restrictions vary from payer to payer (e.g., medical review, prior authorization, and specialty pharmacy
`management)
`Medicaid
`
`Covered in majority of states; coverage guidelines will differ state to state
`
`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`Coverage for EYLEA®(aflibercept) Injection
`
`Panents with Diabetic Ma
`
`Intravitreal injections, including those with EYLEA, have been associated with endophthalmitis and retinal
`detachments. Proper aseptic injection technique must always be used when administering EYLEA. Patients
`should be instructed to report any symptoms suggestive of endophthalmitis or retinal detachment without
`delay and should be managed appropriately. Intraocular inflammation has been
`reported with the use of EYLEA.
`&y EYLEA
`Pleaseseefull Prescribing information availoble from the representative in attendance
`aflibercept) Injection
`For
`intraviveal iyactor
`
`Exhibit 2218
`
`Page 05 of 24
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`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`Commercial Payer Coverage for
`
`Wet- AMD
`% of Total Covered Lives*
`
`Macular Edemafollowing CRVO
`% of Total Covered Lives*
`
`= Parity coverage to
`ranibizumab
`
`Preferred payer
`access for EYLEA
`relative to
`ranibizumab
`
`aget
`
`Payer
`
`Track
`
`®@ Parity coverage
`eee
`to ranibizumab
`
`Preferred
`payer access
`for EYLEA
`relative to
`ranibizumab
`
`Mipase seeful Prescribing informahon avadaile from fhe representativei affendance
`
`Acute increases in intraocular pressure have been seen within 60 minutes of
`intravitreal injection, including with EYLEA. Sustained increases in intraocular
`pressure have also been reported after repeated intravitreal dosing with VEGF
`inhibitors. Intraocular pressure and the perfusion of the optic nerve head should be &y E Y a E A
`monitored and managed appropriatety.
`jafibercept)Injection
`For
`intravitreal Injector
`
`Exhibit 2218
`
`Page 06 of 24
`
`

`

`
`
`
`
`
`
`
`
`
`
`6
`
`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`Exhibit 2218
`Page 07 of 24
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`

`

`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`EYLEA®(aflibercept) Injection Coding:
`Diagnosis and Procedure Codin
`
`Description
`injection of a pharmacologic agent
`Intravitreal
`(separate procedure)
`
`Left eve modifier
`Right eye modifier
`-RT
`Bilateral injection modifier
`-50
`office. HOP: Mosptal outpatient
`
`MDC: Medical
`
`Mipase seeful Prescribing informahon avadaile from fhe representative i affendance
`
`The coding information discussed is provided for informational purposes only, is subject to change,
`and should not be construed as iegal advice. The codes listed abowe may not apply to all patients or
`to all health plans; prowders should exercise independent clinical judgment when selecting codes
`and submitting claims to accurately reflect the services and products furnished to a specific patient.
`
`Select Important Safety Information
`EYLEA (aflibercept) Injection is contraindicated in patients with ocular or periocular infections, active
`intraocular
`inflammation, of known hypersensitivity to aflibercept or to any of the excipients in EYLEA
`
`E Y a E A
`jafibercept)Injection
`For
`intravitreal Injector
`
`Exhibit 2218
`
`Page 08 of 24
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`

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`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`ICD-10 Coding for EYLEA® (aflibercept) Injection:
`
`© For neovascular (wet) age-related macular degeneration (AMD)
`
`on eee
`
`The coding information discussed is provided for informational purposes only, is subject to change,
`and should not be construed as legal advice. The codes listed abowe may not apply to all patients or
`to all health plans; providers should exercise independent clinical judgment when selecting codes
`and submitting claims to accurately reflect the services and products furnished to a specific patient.
`Pigase see full Preseriting Informaton avadable from fhe representative in attendance
`
`i
`eltTaalttl)
`Exudative age-related
`macular degeneration
`
`a
`feeUReTiereects
`
`© Select Important Safety Information
`EYLEA® (aflibercept) Injection is contraindicated in patients with ocular or periocular infections, active
`intraocular inflammation, or known hypersensitivity to aflibercept or to any of the excipients in EYLEA
`
`a EYLEA
`=
`{afibercept) Injection
`=e
`
`Exhibit 2218
`
`Page 09 of 24
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`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`ICD-10 Coding for EYLEA® (aflibercept) Injection:
`Edemafollowing Retinal Vein Occlusion (RVO)
`
`eltraalsitter)
`Retinal edema
`{Primary Diagnosis)
`
`Central RVO
`(SecondaryDiagnosis}
`
`Venous tributary (branch) occlusion
`(Secondary Diagnosis)
`
`a
`ICD-10 diagnosis codes
`
`H35.81
`H34.811 (Right eye)
`134.812 (Left Eye)
`34.813 (Bilateral)
`H34,819 (Unspecified Eye)
`
`H34.831 (Right Eye)
`H34_832 (Left Eye)
`H34,833 (Bilateral)
`H34,839 (Unspecified Eye}
`
`en beeen
`
`Select Important Safety information
`Intravitreal injections, including those with EYLEA, have been associated wathendophthalmitis and retinal detachments.
`Proper aseptic injection techreque must always be used when adeninistering EYLEA. Patients should be instructed to report
`any symptoms suggestive of endophthalmitis or retinal detachment without delay and should be managed appropriately
`intraocular inflammation has been
`reported withthe use of EYLEA
`
`The coding information discussed is provided for informational purposes only, is subject to change,
`and should not be construed as tegal advice. The codes listed abowe may not apply to all patients or
`to all health plans; prowiders should exercise independent clinical judgment when selecting codes
`and submitting claims to accurately reflect the services and products furnished to a specific patient.
`Pigase see full Preseriting Informaton avadable from fhe representative in attendance
`
`a EY L EA
`{afibercept) Injection
`re
`
`Exhibit 2218
`
`Page 10 of 24
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`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`ICD-10 Coding for EYLEA® (aflibercept) Injection: Diabetic
`Macular Edema (DME)
`
`a
`eetRETcect easly
`
`Diabetic Macular Edema
`Type 1 diabetes
`
`Type 1 diabetes with..
`
`£10.311 urspecified diabetic retievopathy [DR] with macular edema [ME]
`£10,321 mild nonproliterative DR with ME
`£10.331 moderate nanprofiferative DA with ME
`£10.341 severe nonproliferative DR with ME
`£10.351 proliferative DA with ME
`
`Pigasesee ful Prescribing informahon avadadle from fhe representative in attendance
`
`©”
`
`”
`
`Note: Coding for the indication of Diabetic Retinopathy in patients with DME is consistent with coding for
`the indication of Diabetic Macular Ederna (DME)
`
`Select Important Safety Information
`including with EYLEA
`Acute increases in intraccular pressure have been seen within 60 minutes of intravitreal injection,
`Sustamed increases im intraocular pressure have also been reported after repeated intravitreal dosing with VEGF inhibaors
`Intraocular pressure andthe pertusion of the optic nerve head should be monitored and managed appropriately
`
`The coding information discussed is provided for informational purposes only, is subject to change,
`and should not be construed as legal advice. The codes listed abowe may not apply to all patients or
`to all health plans; providers should exercise independent clinical judgment when selecting codes
`and submitting claims to accurately reflect the services and products furnished to # specific patient
`
`E Y L E A
`aflibercept) Injection
`For
`intravitreal jecton
`
`Exhibit 2218
`
`Page 11 of 24
`
`10
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`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`ICD-10 Coding for EYLEA® (aflibercept) Injection: Diabetic
`Macular Edema (DME) (cont’d)
`
`Pigase see ful Prescribing informahon avadadle from fhe representative in attendance
`
`Diabetic Macular Edema: Type 2 diabetes
`
`Type 2 diabetes with
`
`Note: An addtional code should be used to
`identify any insulin use
`
`£11,311 unspecified diabetic retinopathy [DA] with macular edema [ME]
`£11.321 mild nonproliferative DR with ME
`£11,331 moderate nonproliferative DR with ME
`£11.34) severe normprolifermive DR with ME
`£11,351 proliferative DA with ME
`
`©
`
`Note Coding for the indication of Olabetic Retinopathyin patients wth OME is consistent with coding for the indication of Diabetic
`Macular Edema (DME
`
`Select Important Safety Information
`There is a potential risk of arterial thromboembolic events (ATES) followingintravitreal use of VEGF infibitors, includingEYLEA. ATEs are
`defined as nonfatal stroke, montatal myocardial infarction, of vascular death
`(including deaths of unknown cause) The incid
`reported thromboembolic events in wet AMD
`ies during the first year was 1.8% (32 owt
`of 1824) in the
`combined group of p
`treated with EYLEA. The incidence in the OME s ies from baseline to week 52 was 3.3% (19 owt of 578) in the combined groupof
`patients treated with EYLEA compared with 2.8% (8 out of 287)
`in the control group;
`from baseline to week 100, the incidence was 6.4%
`(37 aut of 578) in the combined groupof patients treated with EYLEA compared with 4.2% (12 owt of 287)
`in the contro! group. There
`were no reported thromboembolic events in the patients treated with EYLEA wmthe first six months of the RVD stuches.
`
`The coding information discussed is provided for informational purposes only, is subject to change,
`and should not be construed as legal advice. The codes listed abowe may not apply to all patients or y E Y L E A
`to all health plans; providers should exercise independent clinical judgment when selecting codes
`and submitting claims to accurately reflect the services and products furnished to a specific patient.
`jaflibercept) Injection
`For
`intravitreal Injecton
`
`Exhibit 2218
`
`Page 12 of 24
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`11
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`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`ICD-10 Coding for EYLEA® (aflibercept) Injection:
`Diabetes Caused by Another Condition or Event
`
`taleates
`Diabetic Macular Edema
`Diabetes due to underlying condition
`
`The underlying conditions must be coded first: congenital
`rubella; Cushing's syndrome: cystic fibrosis; malignant
`necpsm, mainutmion; pancreatitis and other Gseases of
`the pancreas
`
`An additional code shrould be used to identify ary insulin
`use
`
`a
`ICD-10 diagnostic codes
`
`Diabetes due to underlying condition with
`
`E08.311 unspecified diabetic retinopathy (DR) with macular edema
`(ME}
`£08,321 mild nonproliferative OR with ME
`E08.331 moderate nomproliterative DR with ME
`E08. 341 severe nonproliferative DAR with ME
`E08.351 proliferative OR with ME
`
`intravitreal jecton Pigase see ful Prescribing informahon avadadle from fhe representative in attendance
`
`Note: Coding for the indication of Diabetic Retinopaltry in patients with DME
`Diabet Macular Edema (DME)
`
`consistent with coding for the indication of
`
`Select Important Safety information
`The most common adverse reactions (25%) reported in patients receiving EYLEA were conjunctival hemorrhage, eve pain
`Cataract, vitreous floaters,
`intraocular pressure increased,
`aevd v
`6 detachment
`The coding information discussed is provided for informational purposes only, is subject to change,
`and should not be construed as legal advice. The codes listed abowe may not apply to all patients or
`to all health plans; providers should exercise independent clinical judgment when selecting codes
`and submitting claims to accurately reflect the services and products furnished to a specific patient.
`
`E Y L = A
`jaflibercept) Injection
`For
`
`Exhibit 2218
`
`Page 13 of 24
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`12
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`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`ICD-10 Coding for EYLEA® (aflibercept) Injection:
`Diabetes Caused by Another Condition or Event
`
`ay
`
`ICD-10 diagnostic codes
`
`Diabetic Macular Edema
`Drug of chemical induced diabetes
`
`For these diabetes codes, code first pomoning due to drug or
`toxin,
`f applicable
`
`Use additional code for adverse effect,
`identify drug
`
`if applicable, to
`
`An addtional code should be used toidentify any insulin use
`
`Drug or chemical induced diabetes with
`
`£09.311 unspecified diabetic retinopathy (DR) with macular edema
`(ME)
`£09,321 mild nonproliferative DR with ME
`E09.331 moderate nonproliferative DR with ME
`£09,341 severe nonproliferative DR with ME
`£09.351 proliferative OR with ME
`
`
`
`a
`
`a
`
`Note: Coding for the indication of DiabetRetinopathy in patients with DME is consistent with coding for the indication
`Macular idema (DME)
`
`Select Important Safety information
`dar or periocular infections, active intraocular inflammation, ar
`EYLEA® (aflibercept) injectionis contraindicatedin patients wath
`known hypersensitivity to aflibercept of to erry of the excipients in EYLEA
`
`The coding information discussed is provided for informational purposes only, is subject to change,
`and should not be construed as legal advice. The codes listed abowe may not apply to all patients or
`to all health plans; providers should exercise independent clinical judgment when selecting codes
`and submitting claims to accurately reflect the services and products furnished to a specific patient.
`Pigase see ful Prescribing informahon avadadle from fhe representative in attendance
`
`E Y L = A
`"
`jaflibercept) Injection
`For intraviteal lyacton
`
`Exhibit 2218
`
`Page 14 of 24
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`13
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`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`ICD-10 Coding for EYLEA®(aflibercept) Injection: =
`Other Specified Diabetes
`
`
`
`Diabetic Macular Ederna
`OtherSpecified Diabetes
`
`These new ICD-10 diagnostic codes should be used with the
`following types of diabetes: Gabetes due to genetic defects
`of beta-cell function or in insulin action;
`postpancreatectoenydhabetes, postprocedural diabetes
`vecondary diabetes NEC
`
`An additional code should be used to identify ary insulin use
`
`a
`
`ICD-10 diagnostic codes
`
`Other specified diabetes with
`£13.311 (unspecified diabetic retinopathy (DR) with macular edema (ME)
`£13.321 (mild nonproliferative OR weth ME)
`£13.331 (moderate nomproliferative DR with ME)
`£13.34) (severe nonproliferative DR with ME)
`£13.35! (proliferative OR with ME)
`
`Note: Coding for the indication of Diabetic Retinopathy
`Macular Edema (DME)
`
`“1 patients with DME is consistent with codingfor the imdicatior
`
`Select Important Safety Information
`Intravitreal injections,
`inchuding thase with EYLEA, have been associated with endophthalmitis and retinal detachments. Proper
`aseptic injection technique must always be used when administering EYLEA. Patients should beinstructed to report any symptoms
`suggestive of endophthalmitis or retinal detachrnent wethout delay and should be managed appropriately.
`intraocular inflamenation
`has been reported with the use of EYLEA
`The coding intarmations @scessed is pravided for ntormational purgaves only, whject to change, and should nat be
`e
`
`construed at legal advice. The code: luted above may not apply to all patients or to all health plant providers should Ebyig B E A
`sreducts furnnhed to a specific patient
`eeercse Independentclleical jurgreeat when setecting codes and subemitting claim to accuratety reflect the services and
`laflibercept} Injecton
`For
`intravitreal hyacton
`Pigase see ful Prescribing informmabon avadadle from fhe representative in attendance
`
`Exhibit 2218
`
`Page 15 of 24
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`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`Coding: Product Codesfor
`EYLEA®
`
`“
`
`Description
`
`TT aerated
`
`J0178
`
`Injection, aflibercept, 1 mg*
`
`2
`
`*With the 1 mg descriptor, it is important to accurately indicate “2” billing
`units for each 2 mg injection on the claim form (or electronic equivalent)
`
`10-Digit
`: 11-Digit NDC
`
`ace +)
`Single-use, sterile, 3-mL, glass vial to deliver
`arn Se rs 0.05 mL of 40 mg/mL EYLEA
`
`.
`
`EYLEAis available in the same 2-mg, single-strength formulation for all approved
`indications.
`
`The coding information discussed is provided for informational purposes only, is subject to change, and should not be
`construed as legal advice. The codes listed above may not apply to all patients or to all health plans; providers should
`exercise independent clinical judgment when selecting codes and submitting claims to accurately reflect the services and
`
`productsfurnishedtoaspecific patient.
`
`.
`Pigase see ful Prescribing informaton avadadle from fhe representative in attendance
`
`& EYLEA
`Sy{aflibercept)Injection
`
`For intraviteal lyacton
`
`Exhibit 2218
`
`Page 16 of 24
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`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`PaymentTerminology
`
`ASP
`
`Average Sales Price
`¢ Weighted average of a productssalesless price concessionsacrossall
`purchasing channels
`Reported to Centers for Medicare and Medicaid Services (CMS )
`by the manufacturer each quarter
`
`Wholesale Acquisition Cost
`WAC © Manufacturer'slist price for the drug or biologic to wholesalers or direct
`purchasers
`~ Reported to CMS by the manufacturer each quarter
`
`¢
`
`traviveal hwactor
`
`Bienacele]
`Direct Biien price for a drug or biological to non-wholesaler customers
`
`‘VWEYLEA
`jafibercept)Injection
`ro
`
`Exhibit 2218
`
`Page 17 of 24
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`CONFIDENTIAL MATERIAL- SUBJECT TO PROTECTIVE ORDER
`
`Understanding the Average Sales Price (ASP)
`for EYLEA® (aflibercept)
`Injection
`
`Whyis the ASP for EYLEA relevant?
`
`« Medicare reimburses based upon ASP methodology
`* Commercial payers reimbursement rates are generally based off of
`the ASP methodology
`¢ 53% of physician contracts with commercial payers are based upon ASP
`methodology for payment!
`* Other reimbursement methodologies are based off of AWP or WAC +/-
`a percentage
`
`Whatis the ASP for EYLEA?
`
`* The ASP for EYLEA is $1,850
`
`intraviveal lyactor
`
`WYEYLEA
`jaflibercept)Injection
`For
`
`Exhibit 2218
`
`Page 18 of 24
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`

`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`Physician Office Reimbursement by Payer
`for EYLEA®(aflibercept) Injection
`
`Medicare (FSS) : Reimbursement for EYLEA® (aflibercept) Injection
`is based upon the weighted ASP + 6%
`
`Quarterly Medicare Allowable Rate
`
`responsibility
`
`20%
`
`traviveal hwactor
`
`ASP + 6%
`
`Medicare pays
`
`= 80% of quarterly
`
`rate
`
`ope
`
`Patient
`
`Commercial payers: reimbursementrates vary by payer and may be
`based upon provider/payer contractual arrangements
`
`Medicaid (FFS): Individual States set reimbursement rates based on
`a maximum allowable rate or payment methodology that calculates
`the rate
`& EYLEA
`jafibercept)Injection
`ro
`
`Exhibit 2218
`
`Page 19 of 24
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`CONFIDENTIAL MATERIAL- SUBJECT TO PROTECTIVE ORDER
`
`Sequestration Impact on EYLEA®(aflibercept)
`Injection
`
`Sequestration: Automatic withholding of funding for the
`federal budget in order to reduce the federal deficit by
`$1.2 trillion dollars over 10 years from 2013-2022
`
`ietravireal hwactor
`
`HCPs receive a 2% reduction on all payments (services
`and drugs) received from Medicare
`
`¢ 2% reduction applies to the 80%allowable that Medicare normally pays
`¢ 20%patient co-pay responsibility is NOT affected
`« Sequester reimbursement adjustment for 80% Medicare allowable
`= ASP + 4.3%
`
`QVEYLEA
`jafibercept) Injection
`For
`
`Exhibit 2218
`
`Page 20 of 24
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`

`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`Your Payers Components of Reimbursementfor
`EYLEA®(afli
`t) Injection
`
`” [Nameof MAC, Carrier, or Fl], [Jurisdiction # and
`
`Covered:
`
`/Yes or No]
`
`/[J0178]
`Coding:
`/e.g. ASP+6%/
`Reimbursement Methodology:
`Additional information: [e.g. PA required, Step edit, SP
`required, etc.]
`
`States]:
`
`&yALEA
`
`ietraviveal hyactor
`
`For
`
`Exhibit 2218
`
`Page 21 of 24
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`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`Your Payers Components of Reimbursement for
`EYLEA®(afli
`t) Injection
`
`—
`
`” Medicare Advantage: [Payer name]
`Covered:
`[Yes or No]
`
`[J0178]
`Coding:
`/[e.g. ASP+6%/
`Reimbursement Methodology:
`Additional information: [e.g. PA required, Step edit, SP required, etc.]
`
`” Medicare Advantage: [Payer name]
`Covered:
`[Yes or No]
`
`[J0178]
`Coding:
`[e.g. ASP+6%]
`Reimbursement Methodology:
`Additional information: /e.g. PA required, Step edit, SP required, etc.]
`
`intravitreal jactor
`
`&yEomLEA
`
`For
`
`Exhibit 2218
`
`Page 22 of 24
`
`

`

`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`Your Payers Components of Reimbursementfor
`EYLEA®
`(afli
`t) Injection
`
`“
`
`” Commercial Payer: [Payer name]
`Covered:
`[Yes or No]
`
`[J0178]
`Coding:
`/[e.g. ASP+6%/
`Reimbursement Methodology:
`Additional information: /e.g. PA required, Step edit, SP required, etc.]
`
`intravitreal Injector
`
`” Commercial Payer: [Payer name]
`Covered:
`[Yes or No]
`
`[J0178]
`Coding:
`[e.g. ASP+6%]
`Reimbursement Methodology:
`Additional information: /e.g. PA required, Step edit, SP required, etc.]
`
`Inc
`Note: For reimbursement methodologies using AWP, Regeneron Pharmaceuticals,
`has no involvement
`in the establishment of AWP determinations (which vary among
`data providers) and does not endorse the use of AWP in determining reimbursement
`
`.
`‘yEYLEA
`,
`jafibercept) Injection
`For
`
`Exhibit 2218
`
`Page 23 of 24
`
`

`

`CONFIDENTIAL MATERIAL - SUBJECT TO PROTECTIVE ORDER
`
`Your Payers Components of Reimbursementfor
`EYLEA®(aflibercept) Injection
`
`© [State Medicaid Agency]
`Pharmacy Benefit:
`[Yes or No]
`Covered
`j0178
`Code Required
`[e.g. ASP+6%]
`Reimbursement Methodology:
`Additional
`information:
`[e.g. PA required, Step edit, SP required, etc
`
`Medical Benefit:
`[Yes or No}
`Covered
`(J0178]
`Code Required
`/e.g. ASP+6%/
`Reimbursement Methodology:
`Additional
`information:
`[e.g. PA required, Step edit, SP required, etc.]
`
`Crossover Benefit:
`[Yes or No]
`Covered
`(J0178]
`Code Required
`e.g. ASP+6%]
`Reimbursement Methodology:
`Additional information:
`[e.g. PA required, Step edit, SP required, etc.]
`
`intravireal hywactor
`
`&yAuEA
`
`For
`
`Exhibit 2218
`
`Page 24 of 24
`
`23
`
`