Medical drug program updates
Refer to the chart below to review changes and updates related to CarePartners of Connecticut's prior authorization and coverage program for medical drugs.
New prior authorization programs | ||
| Drug(s) | Effective Date | Policy & additional information |
Bendeka (bendamustine)
| 10/1/2025
| Prior authorization will be required for Bendeka (J9034), approved by the FDA in December 2025 for the treatment of chronic lymphocytic leukemia and non-Hodgkin lymphoma. Bendeka will be a non-preferred bendamustine product within the Medicare Part B Step Therapy Medical Necessity Guideline. |
Posfrea (palonosetron)
| 10/1/2025
| Prior authorization will be required for Posfrea (J2468), approved by the FDA in March 2016 for the treatment of chemotherapy-induced nausea and vomiting in adults and postoperative nausea and vomiting in adults. Posfrea will be a non-preferred antiemetic within the Medicare Part B Step Therapy Medical Necessity Guideline |
| 7/1/2025
| Prior authorization is now required for Opuviz (Q5153), approved by the FDA in May 2024 for the treatment of neovascular (wet) age-related macular degeneration, macular edema following retinal vein occlusion, diabetic macular edema, and diabetic retinopathy. Opuviz will be a non-preferred retinal disorder product within the Medicare Part B Step Therapy Medical Necessity Guideline |
Targeted Immunomodulators – Skilled Administration
| 7/1/2025
| Prior authorization is now required for the following FDA-approved Stelara biosimilars Imuldosa (Q5098), Otulfi (Q9999), Pyzchiva (Q9996, Q9997), Selarsdi (Q9998), Steqeyma (Q5099), Wezlana (Q5137, Q5138), and Yesintek (Q5100).
|
Vyalev (foscarbidopa/foslevodopa)
| 7/1/2025
| Prior authorization is now required for Vvyalev (J7356), approved by the FDA in October 2024 for the treatment of motor fluctuations in adults with advanced Parkinson’s disease.
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