Specialty medical injectable drug program, requirements and drug policy updates for March

New specialty medical injectable updates and requirements announced March 2025.

March 24, 2025

Review the following tables to determine changes to our specialty medical injectable medication programs.

Review at launch
The following specialty medical injectable medications have been added to review at launch:

Medication Name HCPCs Code(s)
Alhemo®
(concizumab-mtci)

J3490/J3590/C9399
Imuldosa™
(ustekinumab-srlf)
Biosimilar to Stelara®		 J3490/J3590/C9399
Niktimvo™
(axatilimab-csfr)		 J3490/J3590/C9399
Otulfi™
(ustekinumab-aauz)
Biosimilar to Stelara		 J3490/J3590/C9399
Steqeyma®
(ustekinumab-stba)
Biosimilar to Stelara		 J3490/J3590/C9399
Yesintek™
(ustekinumab-kfce)
Biosimilar to Stelara		 J3490/J3590/C9399

Note: Medications added to Review at Launch may not yet be available in the marketplace.

Review the UnitedHealthcare Commercial Plan Review at Launch Medication List.

For questions, please contact your broker or UnitedHealthcare representative.

Medication Sourcing for Outpatient Hospital Providers Only
Effective April 1, 2025, the following specialty medical injectable medications are being added to Medication Sourcing for Outpatient Hospital Providers Only:

 

Medication Name HCPCs Code(s) Summary of Changes
Tofidence™
(tocilizumab-bavi)
Biosimilar to Actemra®		 Q5133

Amber Specialty Pharmacy
Tyenne®
(tocilizumab-aazg)
Biosimilar to Actemra		 Q5135
Amber Specialty Pharmacy

Review the UnitedHealthcare Commercial Plan Medication Sourcing List.

For questions, please contact your broker or UnitedHealthcare representative.

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