Specialty medical injectable drug program updates: Nulibry, Abecma and more
New specialty medical injectable guidelines and requirements announced.
- Operations
- All states
- All Business Sizes
Please review the following information 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 |
| Nulibry™ (fosdenopterin) | X | Reduce the risk of mortality in patients with molybdenum cofactor deficiency (MoCD) Type A. |
View the UnitedHealthcare Commercial Plan Review at Launch Medication List.
| Specialty medical injectable drugs added to review at launch for UnitedHealthcare commercial business effective July 1, 2021 | ||
|---|---|---|
Drug Name |
Treatment Uses |
Summary of Changes |
| Abecma® (Idecaptagene Cicleucel) Car-T Cell Therapy |
Adults with relapsed and refractory multiple myeloma. |
|
| Amondys-45™ (casimersen) | Duchenne muscular dystrophy (DMD) patients with mutations amenable to exon 45 skipping. |
|
| Breyanzi® (lisocabtagene maraleucel) Car-T Cell Therapy |
Aggressive relapsing remitting B cell lymphoma. |
|
| Oxlumo™ (lumasiran) | Primary hyperoxaluria type 1 (PH1) in all age groups. |
|
| Synagis® (palivizumab) | Prevention of serious lower respiratory tract disease caused by respiratory syncytial virus in high-risk children. |
|
The updated policy will apply upon prior authorization renewal. 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.
Please contact your broker or UnitedHealthcare representative for more information.
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