Medical drug program updates

You can refer to the chart below to review changes and updates related to CarePartners of Connecticut's prior authorization and coverage program for medical drugs.

Medications being added to prior authorization

Drug(s)  

Effective date

Policy & additional information

Omisirge

10/1/2024

Omisirge

Omisigre (HCPCS J3590), which was approved by the FDA in April 2023 for the treatment of patients with hematologic malignancies, is now covered with prior authorization. MassHealth’s criteria will be used for review.

Anktiva

(nogapendekin alfa inbakicept-pmln)

10/1/2024

Anktiva (nogapendekin alfa inbakicept-pmln)

Prior authorization is now required for Anktiva (HCPCS J9999), approved by the FDA in April 2024 for the treatment of adult patients with Bacillus Calmette-Guérin unresponsive nonmuscle invasive bladder cancer with carcinoma in situ with or without papillary tumors.

Tyenne 

(tocilizumab-aazg)

 

10/1/2024

Targeted Immunomodulators Skilled Administration

Prior authorization is now required for Tyenne (HCPCS Q5135), approved by the FDA in March 2024 for the treatment of adults with rheumatoid arthritis, adults with giant cell arteritis, patients at least 2 years of age with polyarticular juvenile idiopathic arthritis, and patients at least 2 years of age with systemic juvenile idiopathic arthritis.

Updates to existing prior authorization programs 

Givlaari (givosiran)

12/1/2024

Givlaari

Adding provider specialty requirements and updating diagnosis requirements.

Vyjuvek

10/1/2024

Vyjuvek

Updated policy to specify that Vyjuvek will not be authorized in members who are currently on Filsuvez (birch triterpenes topical gel), as combination use with Vyjuvek and Filsuvez has not been studied.

New-to-Market (NTM) Drugs 

10/1/2024 

New to Market (NTM) Drugs

MNG name updated from New to Market (NTM) Drug Evaluation Process Under The Medical Benefit to New to Market (NTM) Drugs.

Minor criteria update to add clarification related to gene therapies.