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Geisinger Health Plan November 2017 Pharmaceutical Policy Updates

Click here to view the Geisinger Health Plan Pharmaceutical Policy Updates »

Pharmaceutical Policy Updates:

Whats New:

  • MBP 40.0 Orencia IV (abatacept)- New Indication
  • MBP 50.0 Vectibix (panitumumab)- Revised Criteria
  • MBP 76.0 Actemra IV (tocilizumab)- Revised Criteria
  • MBP 106.0 Injectable Antipsychotic Medications- New Indication
  • MBP 126.0 Opdivo (nivolumab)- New Indication
  • MBP 128.0 Blincyto (blinatumomab)- Revised criteria
  • MBP 152.0 Bavencio (avelumab)- New Indication
  • MBP 155.0 Ocrevus (ocrelizumab)- Revised Criteria
  • MBP 157.0 Brineura (cerliponase alfa)- New Policy
  • MBP 158.0 Tepadina (thiotepa)- New Policy

The following policies have been reviewed with no change to the policy section. Additional references or background information was added to support the current policy;

  • MBP 59.0 White Blood Cell Stimulating Factors
  • MBP 78.0 Istodax (romidepsin)
  • MBP 110.0 Xofigo (radium Ra 223 dichloride)
  • MBP 114.0 Vimizim (elosulfase alfa)
  • MBP 120.0 Sylvant (siltuximab)
  • MBP 121.0 Dalvance (dalbavancin)
  • MBP 122.0 Sivextro (tedizolid phosphate) IV
  • MBP 136.0 Imlygic (talimogene laherparepvec)
  • MBP 137.0 Yondelis (trabectedin)
  • MBP 138.0 Onivyde (irinotecan liposome injection)
  • MBP 140.0 Empliciti (elotuzumab)
  • MBP 80.0 Xiaflex (collagenase clostridium histolyticum)

 

Click here to view the Geisinger Health Plan Pharmaceutical Policy Updates »

 

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