Effective January 1, 2017, new precertification requirements will
apply to our commercial HMO and PPO members for the medical benefit drugs
listed below:
- Cinqair® (reslizumab)
- Cubicin® (daptomycin)
- Darzalex? (daratumumab)
- Erwinaze® (L-asparaginase)
- Exondys 51™ (eteplirsen)
- Faslodex® (fulvestrant)
- Hymovis® (high molecular weight viscoelastic
hyaluronan)
- Inflectra™ (infliximab)*
- Neulasta® (pegfilgrastim)*
- Neulasta® (pegfilgrastim) Onpro®*
- Sandostatin® LAR (octreotide acetate)
- Tecentriq™ (atezolizumab)
In addition, the following drugs are currently pending approval from the U.S.
Food and Drug Administration (FDA). Once they receive FDA approval, they will
also require precertification approval from AmeriHealth:
- Cingal® (sodium hyaluronate/triamcinolone hexacetonide)
- Ocrevus™ (ocrelizumab)
- Remune® (HIV-1 immunogen)
These changes will be reflected in an updated precertification requirement
list, which will be posted to our websites for
AmeriHealth New Jersey and
for
AmeriHealth Pennsylvania in December, prior
to these changes going into effect. Look for more information about the
availability of this new precertification requirement list in the December 2016
edition of
Partners in Health UpdateSM.
*Precertification requirements apply to all biosimilars
of infliximab and pegfilgratism approved by the FDA.