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Practice paper

Utilising the New Technology Add-on Payment (NTAP): Improving Medicare-insured patients’ access to innovative therapeutics

Jeffrey G. Johnson
Management in Healthcare: A Peer-Reviewed Journal, 8 (4), 367-376 (2024)
https://doi.org/10.69554/SBUO6914

Abstract

Andexanet alfa (Andexxa) is the first reversal agent for direct factor Xa inhibitors. It qualified as a new, novel therapeutic for the New Technology Add-on Payment (NTAP) reimbursement from the Centers for Medicare and Medicaid Services (CMS) in October 2018. This paper is the first analysis of a healthcare system (HCS) reporting its implementation and utilisation of the NTAP for a new therapeutic. The number of patients treated with Andexxa at the level 1 trauma centre of southern New Jersey, Cooper University Hospital (CUH) was analysed. This paper highlights the successful implementation of Andexxa as a treatment option for (non)traumatic intracranial haemorrhage and acute, nongastrointestinal haemorrhage requiring surgical management at CUH. This paper looked at how well CUH obtained the Andexxa NTAP from CMS for Medicare patients. During the 4-year reimbursement period, CUH treated a total of 88 patients with Andexxa, of which 53 were Medicare patients treated before the expiry of the Andexxa NTAP. The study found that CUH received NTAP for 81 per cent of Andexxa-treated Medicare patients and that CUH received the maximal NTAP amount of US$18,281.25 for 43 per cent of those same patients. The paper discusses how a large trauma centre implemented and received the NTAP for Andexxa and evaluates the effect of cost on reimbursement amounts during the Andexxa NTAP period. Finally, this paper should help healthcare providers, stakeholders and administrators better understand the process through which to obtain NTAP reimbursements from CMS and improve their HCS with new, innovative therapies for their patients.

Keywords: reimbursement mechanisms; prospective payment system; Medicare Part A; anticoagulation reversal

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Author's Biography

Jeffrey G. Johnson is a fourth-year medical student at Cooper Medical School of Rowan University (Camden, NJ). He is currently applying to medical residency programmes. Jeffrey received his doctoral degree in 2015 in biological sciences, with an emphasis in synthetic protein chemistry from the Rockefeller University, New York. During his doctoral studies, he was a graduate fellow of the NIH-funded Training Program in Chemical Biology (TPCB Program) of Cornell University, Rockefeller University and Memorial-Sloan Kettering Cancer Center. After obtaining his doctoral degree, Jeffrey worked in the pharmaceutical industry to develop and manufacture new liquid and chewable formulations of attentiondeficit/ hyperactive disorder (ADHD) medications using a newly developed extended-release technology for paediatric and elderly patient populations. His current career goal is to help teenagers and emerging adults positively navigate mental health issues and successfully launch happy, healthy lives.

Citation

Johnson, Jeffrey G. (2024, June 1). Utilising the New Technology Add-on Payment (NTAP): Improving Medicare-insured patients’ access to innovative therapeutics. In the Management in Healthcare: A Peer-Reviewed Journal, Volume 8, Issue 4. https://doi.org/10.69554/SBUO6914.

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cover image, Management in Healthcare: A Peer-Reviewed Journal
Management in Healthcare: A Peer-Reviewed Journal
Volume 8 / Issue 4
© Henry Stewart
Publications LLP

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