Medical drug program updates
New prior authorization programs | ||
Drug(s) | Effective date | Policy & additional Information |
Cosentyx (secukinumab) intravenous | March 1, 2024 | |
Updates to existing prior authorization programs | ||
Drug(s) | Effective date | Policy & additional Information |
Tecvayli (teclistamab-cqyv) | May 1, 2024 | |
Akynzeo, Alymsys, Aponvie, Avastin, Avsola, Beovu, Byooviz, Cimerli, Cinvanti, Durolane, Dysport, Elelyso, Evenity, Eylea, Feraheme, Fusilev, Fylnetra, Gel-One, Gelsyn-3, Genvisc 850, Granix, Herceptin, Herceptin Hylecta, Herzuma, Hyalgan, Hymovis, Injectafer, Khapzory, Lanreotide (cipla), Leukine, LEVOleucovorin, Lucentis, Monoferric, Monovisc, Myobloc, Neupogen, Nivestym, Nyvepria, Ogivri, Ontruzant, Orthovisc, Prolia, Releuko, Renflexis, Riabni, Rituxan, Rituxan Hycela, Rolvedon, Signifor LAR, Soliris, Stimufend, Supartz FX, Sustol, Susvimo, Synojoynt, Synvisc One, Synvisc, Treanda, Triluron, Trivisc, Udenyca, Vabysmo, Vegzelma, Visco-3, Visudyne, Vivimusta, Xgeva, Ziextenzo, Zilretta | May 1, 2024 | |
Oxlumo (lumasiran) | May 1, 2024 | |