Specialty medical injectable drug program requirements and drug policy updates: Amvuttra™, Enjaymo™ and more
New specialty medical injectable updates and requirements announced.
- Operations
- All states
Please review the following tables to determine changes to our specialty medical injectable drug programs.
Specialty medical injectable drugs added to review at launch
| Drug Name | UnitedHealthcare Commercial | Treatment Uses |
| Amvuttra™ (vutrisiran) |
X | Indicated for the treatment of polyneuropathy of hereditary transthyretin-mediated amyloidosis in adults. |
Review the UnitedHealthcare Commercial Plan Review at Launch Medication List.
Updates to drug program requirements and drug policies
For UnitedHealthcare commercial business effective Oct. 1, 2022
| Drug Name | Treatment Uses | Summary of Changes |
| Enjaymo™ (sutimlimab-jome) |
Decrease the need for red blood cell transfusion because of hemolysis in adults with cold agglutinin disease (CAD). | Add notification/prior authorization, Site of Care and Medication Sourcing. |
| Fylnetra™ (pegfilgrastim-pbbk) |
Indicated to prevent febrile neutropenia in individuals receiving chemotherapy. | Add notification/prior authorization. Add preferred product:
|
| Korsuva™ (difelikefalin) |
Moderate to severe itching associated with chronic kidney disease in adults undergoing hemodialysis. | Add notification/prior authorization. |
| Releuko® (filgrastim-ayow) |
Indicated to decrease the incidence of infection, as manifested by febrile neutropenia. | Add notification/prior authorization. Add preferred product:
|
| Tezspire™ (tezepelumab-ekko) |
Add on maintenance treatment of severe asthma in adults and children 12 years and older. | Add notification/prior authorization, Site of Care and Medication Sourcing. Add preferred product for treatment naïve patients with eosinophilic asthma type:
|
Upon prior authorization renewal, the updated policy will apply. UnitedHealthcare will honor all approved prior authorizations on file until the end date on the authorization or the date the member’s eligibility changes. Providers don’t need to submit a new notification/prior authorization request for members who already have an authorization for these medications on the effective date noted above.
For questions, please contact your broker or UnitedHealthcare representative.
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