New prior authorization required for specialty asthma medication Fasenra – effective April 1

The U.S. Food and Drug Administration (FDA) recently approved Fasenra (benralizumab), a specialty injectable medication used to treat patients with severe asthma who have an eosinophilic phenotype. For dates of service before April 1, 2018, we strongly encourage providers request pre-service coverage reviews so they can check whether a medication is covered before providing services. Starting April 1, 2018, providers will need to request prior authorization if they choose to prescribe Fasenra (benralizumab) to their patients who are UnitedHealthcare Commercial members.

The notification/prior authorization requirement will apply to all UnitedHealthcare commercial plans including:

  • UnitedHealthcare of the Mid-Atlantic
  • UnitedHealthcare Oxford
  • Neighborhood Health Partnership (NHP)
  • UnitedHealthcare of the River Valley

Failure to complete the Prior Authorization process prior to the administration could result in claim denial. Health care providers cannot bill members for services that are denied for failure to complete the Prior Authorization process.

For more information, visit UnitedHealthcare’s Specialty Pharmacy Information Center or contact your UnitedHealthcare representative.