Specialty medical injectable drug program, requirements and drug policy update

New specialty medical injectable updates and requirements announced.

Oct. 17, 2022
  • Operations
  • All states
  • All Business Sizes

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
Xenpozyme®
(olipudase alfa)		 X Indicated for the treatment of non-central nervous system manifestations of acid sphingomyelinase deficiency (ASMD) in pediatric and adult patients with ASMD type A/B or ASMD type B.
Spevigo®
(spesolimab-sbzo)		 X Indicated for the treatment of general pustular psoriasis (GPP) flares in adults.

Download the UnitedHealthcare Commercial Plan Review at Launch Medication List to learn more.*


Updates to drug program requirements and drug policies for UnitedHealthcare commercial business effective Nov. 1, 2022

Updates to drug program requirements and drug policies
Drug Name Treatment Uses Summary of Changes
Amvuttra™ (vutrisiran) Used to treat polyneuropathy caused by hereditary transthyretin-mediated (hATTR) amyloidosis in adults.
  • Add notification/prior authorization, Site of Care, and Medication Sourcing
Skysona®
(elivaldogene autotemcel)		 Used to treat cerebral adrenoleukodystrophy (CALD), a rare X-linked genetic disease that mainly affects the nervous system and adrenal glands.
  • Add notification/prior authorization
  • Will be managed by Optum Transplant
Zynteglo™ (betibeglogene autotemcel) One-time treatment for a blood disorder known as beta thalassemia in adult and pediatric patients who require regular blood transfusions.
  • Add notification/prior authorization
  • Will be managed by Optum Transplant

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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