Specialty medical injectable drug program, requirements and drug policy updates

New specialty medical injectable updates and requirements announced.

Dec. 5, 2022

Please review the following tables to determine changes to our specialty medical injectable drug programs.

Specialty medical injectable drugs added to review at launch

Updates to drug program requirements and drug policies
Drug Name UnitedHealthcare Commercial Treatment Uses
Tzield™
(teplizumab-mzwv)		 X Used to delay the clinical onset of Type 1 Diabetes Mellitus (DM) in individuals at high risk for developing the disease.
Hemgenix
(etranacogene dezaparvovec)		 X Gene therapy used for the treatment of Hemophilia B in adults.

Review the UnitedHealthcare Commercial Plan Review at Launch Medication List.

Note: Certain specialty medical injectable drug programs and updates will not be implemented at this time for providers practicing in Rhode Island, with respect to certain commercial members, pursuant to the Rhode Island regulation: 230 -RICR-20-30-14. UnitedHealthcare encourages providers practicing in Rhode Island to call in to confirm if prior authorization is required.
This exception does not apply to Medicaid and Medicare.

For questions, please contact your broker or UnitedHealthcare representative.

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