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Pharmacy Medical Policy Updates

The following Pharmacy Medical Policy programs have been updated June 1, 2023:

Effective July 1, 2023:

  • Healthcare Administered Multiple Sclerosis
  • Antifungals (formerly Antifungal Agents [Brexafemme/Cresemba/Noxafil/Vfend/Vivjoa])
  • Parathyroid Hormone Analog Osteoporosis
  • Rituximab
  • Tezspire
  • Urea Cycle Disorders
  • Biologic Immunomodulators
  • Vijoice
  • Fintepla
  • Continuous Glucose Monitoring Systems (CGM)
  • Acute Migraine Agents
  • CGRP
  • Enjaymo

The following policies are archiving due to being retired:

Effective May 1, 2023:

  • Gabapentin ER  

Effective June 1, 2023:

  • Lucemyra 

Many of our pharmacy medical policies are maintained through our pharmacy benefit manager, Prime Therapeutics.

To find pharmacy medical policies specific to a medication list, please select a medication list at the bottom of our prior authorization page of our website, https://www.bcbsks.com/providers/precertification-prior-authorization

If you have any questions regarding this newsletter, please contact your BCBSKS provider representative/consultant.

Institutional Providers
Professional Providers