LEADERSHIP FLY-IN Washington, D.C. June 26-28, 2012 US GAPP LEADERSHIP FLY-IN Washington, D.C. June 26-28, 2012 US GAPP

IVIG Home Infusion: Getting the Right Care in the Right Setting Jed Perry Director BioScience Federal Legislative Affairs

Key Message Cosponsor legislation to improve coverage of IVIG home infusion therapy for Medicare beneficiaries with Primary Immune Deficiency to reduce exposure to infection and make care available in the most appropriate setting.

What is the Problem? The Medicare Modernization Act (MMA) provided Medicare reimbursement for intravenous immunoglobulin (IVIG) therapy infused in the home for patients with primary immune deficiency disorder (PIDD). MMA did NOT provide reimbursement for nursing and supplies associated with home infusion therapies, leaving most unable to utilize the benefit. As a Result: Medicare patients with PIDD who want to receive their therapy at home must pay for nursing and supplies themselves, or are limited to subcutaneous infusion

Baxter’s Goal To ensure the right care is provided in the right setting, patients with already compromised immune systems should have access to all treatment options to best treat their condition and prevent unnecessary complications.

The Solution for Patients Provide Medicare reimbursement for nursing services and supplies for the administration of IVIG in the home. Restores intent of Congress to provide reimbursement for IVIG immune therapy in the home. Exposure to fewer infections. Right care in the right setting.

The Medicare IVIG Access Act H.R (Reps. Kevin Brady and Doris Matsui) S. 960 (Sens. John Kerry and Lamar Alexander) Provides 3-year demonstration project for Medicare reimbursement of supplies and nursing services associated with intravenous immune globulin (IVIG) administered in the home for patients with PIDD. Capped at 4,000 beneficiaries Paid for by Medicare coverage of disposable pumps for administration of a drug to treat colorectal cancer in certain cases. Cost of Legislation: ~$40 million over 10 years

Pay-for/Offset Medicare only pays for electronic durable pumps, and not the disposable pump for colorectal cancer, under Durable Medical Equipment (DME) benefit in the home. – $3,178 a year for durable pumps compared to $1,300 a year for disposable pumps.. Pay-for/Offset: Allow disposable pumps to be covered under the DME benefit.

Key Messaging 1.The Ask: – House: Baxter urges cosponsorship of H.R to improve coverage of IVIG home infusion therapy for Medicare beneficiaries with Primary Immune Deficiency to reduce exposure to infection and make care available in the most appropriate setting. – Senate: Baxter urges cosponsorship of S. 960 to improve coverage of IVIG home infusion therapy for Medicare beneficiaries with Primary Immune Deficiency to reduce exposure to infection and make care available in the most appropriate setting. 2.More appropriate for these patients, who also may be disabled, to receive their infusion at home, not in a hospital setting. 3.Legislation is supported by patient groups.