Humana February 2018 Pharmacy Policy Updates

Click here to view the Humana Pharmacy Policy Updates »

February 2018 Pharmacy Policy Updates

• Opioid Utilization Program – Morphine equivalent dose (MED) edits
• Luxturna™ (voretigene neparvovec-rzyl)
• Steglujan™ (ertugliflozin and sitagliptin)
• ADHD Long Acting Stimulants
• Seroquel XR® (quetiapine fumarate) extended release tablets
• Topical Testosterone
• Alunbrig™ (brigatinib)
• SGLT2 Inhibitors
• Taclonex® (calcipotriene and betamethasone dipropionate)
• Afinitor® (everolimus)/Afinitor Disperz® (everolimus tablets for oral suspension)
• Aldurazyme® (laronidase)
• Ampyra® (dalfampridine)
• Aubagio® (teriflunomide)
• Avonex® (interferon beta-1a)
• Celebrex® (celecoxib)
• Celecoxib (generic for Celebrex®)
• Cerdelga® (eliglustat)
• Cerezyme® (imiglucerase)
• Cimzia® (certolizumab pegol)
• Colchicine Capsules and Tablets
• Continuous Glucose Monitoring Systems
• Duexis® (ibuprofen-famotidine)
• Elelyso® (taliglucerase alfa)
• Enbrel® (etanercept)
• Enstilar® (calcipotriene and betamethasone dipropionate)
• Erivedge® (vismodegib)
• Eucrisa® (crisaborole)
• Extavia® (interferon beta-1b)
• Eylea® (aflibercept injection)
• Factor IX Replacement Products (Hemophilia B)
• Granix® (tbo-filgrastim)
• Humira® (adalimumab)
• Iressa® (gefitinib)
• Jevtana® (cabazitaxel)
• Kineret® (anakinra)
• Krystexxa® (pegloticase)
• Long Acting Muscarinic Antagonist / Long Acting Beta Agonist Combination Inhalers
• Long Acting Opioids
• Lonsurf® (trifluridine and tipiracil)
• Lyrica® CR (pregabalin)
• Medication Waste
• NSAID Combination Products
• Naglazyme® (galsulfase)
• Naprelan® (naproxen sodium controlled-release)
• Ocrevus™ (ocrelizumab)
• Odomzo® (sonidegib)
• Opioid Utilization Program – Morphine equivalent dose (MED) edits
• Oxandrolone
• Oxycontin® (oxycodone hydrochloride controlled release)
• Plegridy® (peginterferon beta-1a)
• Prevymis™ (letermovir)
• Procysbi® (cysteamine)
• Proton Pump Inhibitors
• Provenge® (sipuleucel-T)
• Remicade Biosimilars
• Remicade® (infliximab)
• Repatha (evolocumab)
• Simponi® Aria™ (golimumab)
• Solosec™ (secnidazole)
• Sublocade™ (buprenorphine extended-release)
• Taltz® (ixekizumab)
• Tecfidera® (dimethyl fumarate)
• Topical Psoriasis Agents
• Trulance® (plecanatide)
• Uloric® (febuxostat)
• VPRIV® (velaglucerase alfa)
• Vivlodex® (meloxicam)
• Xalkori® (crizotinib)
• Xofigo® (radium Ra 223 dichloride)
• Xtandi® (enzalutamide)
• Zavesca® (miglustat)
• Zinbryta™ (daclizumab)
• Zipsor® (diclofenac potassium)
• Zorvolex® (diclofenac), Tivorbex® (indomethacin)
• Zurampic® (lesinurad), Duzallo® (lesinurad and allopurinol)
• Cambia® (diclofenac)
• Endari™ (L-glutamine)
• SGLT2 Inhibitors

Click here to view the Humana Pharmacy Policy Updates »

Policy Alerts monitors Commercial and Medicare medical policies for changes. While Payers typically update medical policies annually, there are many reasons why a Payer might review or update a policy. When reviews occur out of cycle, they may go unnoticed. Policy Alerts keeps you informed of upcoming and unexpected coverage changes affecting your product. Quickly understanding the changes Payers make can help you adjust reimbursement strategies impacting your business.

Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on Payer decisions in real-time. Whenever changes occur, email notifications containing a summary of those changes are delivered to your inbox. Clients can access detailed coverage reports and medical policies on the interactive Dashboard portal. Save time and keep focused on the important Payer medical policy reviews and coverage decisions affecting your product!

Policy Alerts takes a client-focused hands-on approach and works hard to provide our customers with helpful insights and actionable analytics over raw data. We understand what our clients need and we are dedicated to making sure we provide timely, accurate and always up-to-date reports that can be used to implement and support a successful reimbursement strategy.

Health economic and reimbursement information provided by Policy Alerts is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.