Medical drug program updates
Medications being added to prior authorization | ||
Drug(s) | Effective date | Policy & additional Information |
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| 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) |
| 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. |
Drug(s) | Effective date | Policy & additional Information |
Hemgenix (etranacogene dezaparvovec-drlb)
Lyfgenia (lovotibeglogene autotemcel)
Roctavian (valoctocogene roxaparvovec-rvox)
Zynteglo (betibeglogene autotemcel)
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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. |
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Casgevy will now be covered with prior authorization for an additional indication: treatment resistant betra-thalassemia |
Carvykti (ciltacabtagene autoleucel)
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| Carvykti (ciltacabtagene autoleucel) Carvykti has moved from a fourth-line treatment to a second-line treatment. |
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| Abecma (idecabtagene vicleucel) Abecma has moved from a fourth-line treatment to a third-line treatment. |