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Journal of Medicinal Chemistry (2017) Kraus D, et al

Beyond its redox coenzyme activity, NAD + serves as a substrate for sirtuins, poly(ADP-ribose) polymerases (PARPs), and other signaling enzymes that consume NAD + during the processes of DNA repair, deacetylation, and cellular stress response

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Methylcobalamin enhances red blood cell production, improves oxygen delivery, and supports healthy nerve function, helping to alleviate conditions like fatigue and neuropathy

Ophthalmic administration of ketorolac may result in impaired wound healing of the eye and keratitis

Comment: Two commenters expressed support for the second alternative discussed in the proposed rule, but requested that it be modified by calculating the first component of the payment limit with the volume-weighted average of the positive ASP data from the previous four quarters for which positive data are available for the biosimilar, rather than only the most recent calendar quarter for which data are available