Medical drug program updates
New prior authorization programs | ||
MNG title | Effective date | Summary |
Jan. 1, 2024 | Step Therapy is now required for Eylea HD (HCPCS C9161), approved August 2023, for the treatment of neovascular (wet) age-related macular degeneration, diabetic macular edema, and diabetic retinopathy. | |
Jan. 1, 2024 | Prior authorization is now required for Izervay (HCPCS C9162), approved August 2023, for the treatment of geographic atrophy secondary to age-related macular degeneration. | |
Jan. 1, 2024 | Prior authorization is now required for Daxxify (HCPCS C9160), approved August 2023, for the treatment of cervical dystonia in adult patients. | |
Jan 1, 2024 | Prior authorization is now required for Roctavian (HCPCS J1412), approved June 2023 for the treatment of adults with severe Hemophilia A. | |
Jan 1, 2024 | Prior authorization is now required for Vyjuvek (HCPCS J3401), approved May 2023 for members 6 months of age and older with dystrophic epidermolysis bullosa with pathogenic variant(s) in the collagen type VII alpha 1 chain (COL7A1) gene. | |
Updates to existing prior authorization programs | ||
Drug(s) | Effective date | Policy & additional Information |
Cinqair, Fasenra, Nucala | Mar. 1, 2024 | |
Epoprostenol products, Remodulin, Tyvaso, Ventavis | Mar. 1, 2024 | |
Crysvita | Mar. 1, 2024 | |