​Effective February 7, 2022, AmeriHealth will update coverage criteria for:

• pegfilgrastim (Neulasta®)
• pegfilgrastim-apgf (Nyvepria™)​
  
• pegfilgrastim-bmez (Ziextenzo®)
• pegfilgrastim-cbqv (Udenyca®)
• pegfilgrastim-jmdb (Fulphila®)

The changes align with the current recommendations from drug compendia, such as The National Comprehensive Cancer Network (NCCN) and Professional Guidelines from the American Society of Clinical Oncology: Recommendations for the Use of WBC Growth Factors.

A Policy Notification for #08.01.32f: Pegfilgrastim (Neulasta®) and related biosimilars was posted on November 9, 2021. The policy changes include the removal of criteria for individuals with these conditions:

• Prophylaxis of chemotherapy-induced febrile neutropenia (regardless of risk status) in individuals with acute myeloid leukemia (AML) who are septic and have a life-threatening infection, when receiving induction chemotherapy.
• Intermittent use in individuals with myelodysplastic syndromes (MDS) who have severe neutropenia and recurrent infection.