Medical & Reimbursement Policies
Medication Policies
- ALPHA 1 PROTEINASE INHIBITORS
- ALZHEIMER'S ANTIAMYLOID MONOCLONAL ANTIBODIES
- AMVUTTRA (VUTRISIRAN) AND ONPATTRO (PATISIRAN)
- BOTULINUM TOXINS
- BRINEURA (CERLIPONASE ALFA)
- CHIMERIC ANTIGEN RECEPTOR T CELL (CAR-T) IMMUNOTHERAPY
- CORTICOTROPIN (H.P. ACTHAR, PURIFIED CORTROPHIN GEL)
- CRYSVITA (BUROSUMAB-TWZA)
- CYTOKINE AND CAM ANTAGONISTS
- DUCHENNE MUSCULAR DYSTROPHY (DMD)
- ENZYME REPLACEMENT THERAPY: POMPE DISEASE
- ERYTHROPOIESIS STIMULATING AGENTS
- EVKEEZA (EVINACUMAB-DGNB)
- FABRY DISEASE MEDICATIONS
- GAUCHER DISEASE: ENZYME REPLACEMENT THERAPY
- GENE THERAPY AGENTS
- GIVLAARI (GIVOSIRAN)
- HEREDITARY ANGIOEDEMA (HAE) AGENTS
- IMCIVREE (SETMELANOTIDE)
- IMMUNE GLOBULINS
- KRYSTEXXA (PEGLOTICASE)
- LANTIDRA (DONISLECEL-JUJU)
- LUTATHERA (LUTETIUM LU 177 DOTATATE)
- LUXTURNA (VORETIGENE NEPARVOVEC-RZYL)
- MEDICAL NECESSITY MEDICATIONS
- MEDICAL STEP THERAPY
- NATALIZUMAB AND NATALIZUMAB BIOSIMILAR
- MYASTHENIA GRAVIS MEDICATIONS
- PULMONARY ARTERIAL HYPERTENSION (PAH) INJECTABLE AGENTS
- QALSODY (TOFERSEN)
- RITUXIMAB PRODUCTS
- SANDOSTATIN LAR DEPOT
- SOMATULINE DEPOT (LANREOTIDE ACETATE)
- STRENSIQ (ASFOTASE ALFA)
- TEPEZZA (TEPROTUMUMAB-TRBW)
- TESTOSTERONE SUPPLEMENTATION
- TZIELD (TEPLIZUMAB-MZWV)
- UPLIZNA (INEBILIZUMAB-CDON)
- VASCULAR ENDOTHELIAL GROWTH FACTOR INHIBITORS (VEGF) AND VISUDYNE (VERTEPORFIN)
- VYEPTI (EPTINEZUMAB)
- XENPOZYME (OLIPUDASE ALFA-RPCP)
- XIAFLEX (COLLAGENASE CLOSTRIDIUM HISTOLYTICUM)
- YCANTH (CANTHARIDIN)
- ZOLGENSMA (ONASEMNOGENE ABEPARVOVEC-XIOI)
