Medical drug program updates

Medications being added to prior authorization

Drug(s)

Effective date

Policy & additional Information


Ryzneuta (efbemalenograstim alfa)

 


7/1/2024


Medicare Part B Step Therapy

Prior authorization is now required for Ryzneuta (J9361), approved by the FDA in Nov. 2023 to decrease the incidence of infection, as manifested by febrile neutropenia, in adults with non-myeloid malignancies receiving myelosuppressive anti-cancer drugs associated with a clinically significant incidence of febrile neutropenia. 

 

Amtagvi (lifileucel)


7/1/2024


Amtagvi (lifileucel)

Amtagvi, a tumor derived autologous T cell immunotherapy approved by the FDA in March 2024 for the treatment of adult patient with unresectable or metastatic melanoma, is covered with prior authorization. 

Updates to existing prior authorization programs

Drug(s)

Effective date

Policy & additional Information


Adstiladrin (nadofaragene firadenovec-vncg)

 

 

Hemgenix (etranacogene dezaparvovec-drlb)

 

Lyfgenia (lovotibeglogene autotemcel)

 

Roctavian (valoctocogene roxaparvovec-rvox)

 

Zynteglo (betibeglogene autotemcel)

 


7/1/2024


Adstiladrin (nadofaragene firadenovec-vncg)


Hemgenix (etranacogene dezaparvovec-drlb)

Lyfgenia (lovotibeglogene autotemcel)

Roctavian (valoctocogene roxaparvovec-rvox)

Zynteglo® (betibeglogene autotemcel)

CarePartners of Connecticut will now use MassHealth criteria for prior authorization review for these gene therapies.


Casgevy (exagamglogene autotemcel)


7/1/2024


Casgevy (exagamglogene autotemcel)

Casgevy will now be covered with prior authorization for an additional indication: treatment resistant betra-thalassemia

 

Carvykti (ciltacabtagene autoleucel)

 


7/1/2024

Carvykti (ciltacabtagene autoleucel)

Carvykti has moved from a fourth-line treatment to a second-line treatment.


Abecma (idecabtagene vicleucel)

 


7/1/2024

Abecma (idecabtagene vicleucel)

Abecma has moved from a fourth-line treatment to a third-line treatment.