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.

 

New prior authorization programs 

 

 

Drug(s) and policy

 

Effective date

 

 

Additional information

 

Niktimvo (axatilimab-csfr)

 

4/1/2025

 

Prior authorization is now required for Niktivmo (HCPCS J3590), approved by the FDA in August 2024 for the treatment of chronic graft-versus-host disease (cGVHD) after failure of at least two prior lines of systemic therapy in adult and pediatric patients weighing at least 40 kg.

 

 

Hympavzi (marstacimab-hncq)

 

4/1/2025

 

Prior authorization is now required for Hympavzi (HCPCS J3590), approved by the FDA in October 2024 for routine prophylaxis to prevent or reduce the frequency of bleeding episodes in adult and pediatric patients 12 years of age and older with hemophilia A without factor VIII inhibitors or hemophilia B without factor IX inhibitors.

 

 

Aucatzyl

 

4/1/2025 

 

Prior authorization is now required for Aucatzyl (HCPCS C9301), a CD19-directed genetically modified autologous T cell immunotherapy indicated for the treatment of adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).

 

 

Tecelra 

 

4/1/2025

 

Prior authorization is now required for the CAR t-cell medication Tecelra (HCPCS Q2057). 

 

 

 

Updates to existing prior authorization programs 

 

 

Drug(s) and policy

 

 

Effective date

 

Additional information

 

Hemlibra (emicizumab-kxwh)

 

6/1/2025

 

Adding requirement that patients have severe hemophilia as defined by less than 1% of endogenous factor VIII.

 

 

Breyanzi

 

4/1/2025

 

Criteria updated to remove a limitation in alignment with National Comprehensive Cancer Network guidelines and published journals.