Effective August 21, 2023, AmeriHealth HMO, Inc., AmeriHealth Insurance Company of New Jersey, and AmeriHealth Administrators will update their Luspatercept–aamt (Reblozyl®) policies to include coverage for beta thalassemia and myelodysplastic syndromes for Commercial members.
This policy was updated to communicate the company's coverage position for beta thalassemia and myelodysplastic syndromes, in alignment with U.S. Food and Drug Administration (FDA) prescribing information and the National Comprehensive Cancer Network (NCCN).
A baseline hemoglobin (Hgb) level of less than or equal to 11 g/dL was added as a criterion for beta thalassemia and myelodysplastic syndromes. Serum erythropoietin levels were added as criteria for lower risk (defined as International Prognostic Scoring System [IPSS-R] Very Low, Low, Intermediate) myelodysplastic syndromes.
For more information, please view #:08.00.10c: Luspatercept-aamt (Reblozyl®), which was published as a notification on May 22, 2023.