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Pharmacy Benefit Updates

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Pharmacy Benefit Updates Pharmacy Benefit Updates DATE: September 12, 2014 TO: All BMC HealthNet Plan Provide rs PRODUCT: MassHealth Commonwealth Care Commercial ConnectorCare/Qualified Health Plan Effective Date: November 12, 2014 Policy Changes The following clinical policies will be updated: • Antineoplastic Agents (9.041) • Botulinum Toxin (9.106) • Hepatitis C Medications (9.123) • Growth Hormone and IGF-1 (9.125) Prior Authorization Program The following drugs will be added to the Prior Authorization Program • Caprelsa® • Giazo® • Signifor® • Copaxone® 40mg/ml • Imbruvica™ • Sylvant® • Cyramza™ • Marqibo® • Tafinlar® • Folotyn® • Mekinist™ • Zelboraf® • Fulyzaq® • Procysbi™ • Zykadia™ • Gattex® Please note the restrictions listed for these policies/medications may differ by plan product. Please visit the Pharmacy section of bmchp.org for complete policies and forms. Two Copley Place • Suite 600 • Boston, MA 02116 • WWW.BMCHP.ORG bmchp.org | 888-566-0008 wellsense.org | 877-957-1300 Clinical Coverage Guidelines Antineoplastic Agents BMCHP refers to Boston Medical Center HealthNet Plan in Massachusetts and Well Sense Health Plan in New Hampshire. Boston Medical Center HealthNet Plan and Well Sense Health Plan are trade names used by Boston Medical Center Health Plan, Inc. BMC HealthNet Plan Well Sense Health Plan Policy Applicability MassHealth New Hampshire Medicaid Commonwealth Care Commercial ConnectorCare/Qualified Health Plan (QHP) Effective Date: 11/12/2014 Policy Number: 9.041 Policy Effective Date: 10/01/2013 Last Review Date: 07/10/2014 Approved by: Pharmacy and Therapeutics Committee Policy Owner/Title: Pharmacy Services Summary BMC HealthNet Plan will authorize coverage of the following antineoplastic agents when appropriate criteria are met. Description of Item or Service Antineoplastic agents are used in the treatment of various oncology diagnoses. New antineoplastic agents are entering the market monthly, reflected in the increasingly vast array of treatment options for patients with This guideline provides information on BMC HealthNet Plan clinical criteria and claims adjudication processing guidelines. The use of this guideline is not a guarantee of payment and will not determine how a specific claim(s) will be paid. Reimbursement is based on member benefits and eligibility, medical necessity review, where applicable, coordination of benefits, adherence to Plan policies, clinical coding criteria, and the BMC HealthNet Plan agreement with the rendering or dispensing provider. Reimbursement policies may be amended at BMC HealthNet Plan’s discretion. BMC HealthNet Plan will always use the most recent CPT and HCPCS coding guidelines. All Plan policies are developed in accordance with state, federal and accrediting organization guidelines and requirements, including NCQA. BMCHP refers to Boston Medical Center HealthNet Plan in Massachusetts and Well Sense Health Plan in New Hampshire. Boston Medical Center HealthNet Plan and Well Sense Health Plan are trade names used by Boston Medical Center Health Plan, Inc. BMC HealthNet Plan – Antineoplastic Agents 1 of 8 oncology diagnoses. These agents differ in their mechanism of action, FDA-approved indications, off-label uses, route of administration, drug interactions and adverse effects. Clinical Guideline Statement Policy Applicability by Product Medication BMC Health Plan MassHealth CWC COMM QHP AdcetrisTM X X X X Caprelsa X X X X Cyramza X X X X Erwinaze X X X X Gilotrif X X X X Icusig X X X X Imbruvica X X X X Inlyta X X X X Kadcyla X X X X Kyprolis X X X X Marqibo X X X X Mekinist X X X X Pomalyst X X X X Stivarga X X X X Sylvant X X X X Synribo X X X X Tafinlar X X X X Zaltrap X X X X Zelboraf X X X X Zykadia X X X X NF=non-formulary BMC HealthNet Plan may authorize coverage of the following antineoplastic agents for members meeting the following criteria: Prior Authorization – (Duration of Approval – Maximum of 1 year) A prior authorization request will be required for all prescriptions for the following antineoplastic agents. These requests will be approved when the following criteria are met: Medication Prior Authorization Criteria This guideline provides information on BMC HealthNet Plan clinical criteria and claims adjudication processing guidelines. The use of this guideline is not a guarantee of payment and will not determine how a specific claim(s) will be paid. Reimbursement is based on member benefits and eligibility, medical necessity review, where applicable, coordination of benefits, adherence to Plan policies, clinical coding criteria, and the BMC HealthNet Plan agreement with the rendering or dispensing provider. Reimbursement policies may be amended at BMC HealthNet Plan’s discretion. BMC HealthNet Plan will always use the most recent CPT and HCPCS coding guidelines. All Plan policies are developed in accordance with state, federal and accrediting organization guidelines and requirements, including NCQA. BMCHP refers to Boston Medical Center HealthNet Plan in Massachusetts and Well Sense Health Plan in New Hampshire. Boston Medical Center HealthNet Plan and Well Sense Health Plan are trade names used by Boston Medical Center Health Plan, Inc. BMC HealthNet Plan – Antineoplastic Agents 2 of 8 All requests for the antineoplastic agents listed in the table below will require the following documentation: • The quantity of medication prescribed is consistent with dosing listed in manufacturer package labeling for the prescribed indication • The prescriber is a specialist appropriate to the disease state being treated (e.g. oncologist, hematologist, etc). • For non-FDA approved indications, the member must have a diagnosis consistent with recommended usage of the medication as listed in the NCCN Compendia AND has had an inadequate response, contraindication or adverse effect to standard treatment options if applicable. AdcetrisTM Documentation of the following: (brentuximab injection) 1. A diagnosis of Hodgkin lymphoma; AND An inadequate response to at least 2 prior chemotherapy regimens (in patients ineligible for stem cell transplant) or a treatment failure of stem cell transplant; OR 2. A diagnosis of systemic anaplastic large cell lymphoma (sALCL); AND An inadequate response to at least 1 prior chemotherapy regimen ErwinazeTM Documentation of the following: (erwinia asparaginase 1. A diagnosis of acute lymphoblastic leukemia (ALL); AND injection) 2. Member is currently receiving treatment with other chemotherapy; AND 3. There is a hypersensitivity to E. coli-derived asparaginase Inlyta® Documentation of the following: (axitinib tablet) 1. A diagnosis of advanced renal cell cancer (RCC); AND 2. An inadequate response to 1 prior treatment Kyprolis® Documentation of the following: (carfilzomib injection) 1. A diagnosis of multiple myeloma; AND 2. An inadequate response to at least 2 prior complete treatment regimens including a proteasome inhibitor and immunomodulator Zaltrap® Documentation of the following: (ziv-aflibercept injection) 1. A diagnosis of metastatic colorectal cancer; AND 2. An inadequate response to an oxiplatin-based regimen; AND 3. The medication will be used in combination with fluorouracil, leucovorin and irinotecan [FOLFIRI] or irinotecan alone Bosulif® Documentation of the following: (bosutinib tablet) 1. A diagnosis of chronic, accelerated or blast phase Philadelphia chromosome- positive (Ph+) chronic myelogenous leukemia (CML); AND 2. An inadequate response or intolerance to any prior therapy This guideline provides information on BMC HealthNet Plan clinical criteria and claims adjudication processing guidelines. The use of this guideline is not a guarantee of payment and will not determine how a specific claim(s) will be paid. Reimbursement is based on member benefits and eligibility, medical necessity review, where applicable, coordination of benefits, adherence to Plan policies, clinical coding criteria, and the BMC HealthNet Plan agreement with the rendering or dispensing provider. Reimbursement policies may be amended at BMC HealthNet Plan’s discretion. BMC HealthNet Plan will always use the most recent CPT and HCPCS coding guidelines. All Plan policies are developed in accordance with state, federal and accrediting organization guidelines and requirements, including NCQA. BMCHP refers to Boston Medical Center HealthNet Plan in Massachusetts and Well Sense Health Plan in New Hampshire. Boston Medical Center HealthNet Plan and Well Sense Health Plan are trade names used by Boston Medical Center Health Plan, Inc. BMC HealthNet Plan – Antineoplastic Agents 3 of 8 Stivarga® Documentation of the following: (regorafenib tablet) 1. A diagnosis of metastatic colorectal cancer; AND Previous treatment with fluoropyrimidine-, oxiplatin-, and irinotecan-based therapy, anti-VEGF therapy, or anti-EGFR therapy; OR 2. A diagnosis of locally-advanced, unresectable, or metastatic gastrointestinal stromal tumor (GIST); AND Previous treatment with imatinib and sunitinib SynriboTM Documentation of the following: (omacetaxine injection) 1. A diagnosis of chronic or accelerated phase chronic myelogenous leukemia (CML); AND 2. Resistance or intolerance to 2 or more tyrosine kinase inhibitors IclusigTM Documentation of the following: (ponatinib tablet) 1. A diagnosis of chronic, accelerated, or blast phase chronic myelogenous leukemia (CML) OR Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL); AND 2. Resistance or intolerance to prior tyrosine kinase inhibitor therapy OR a diagnosis of CML with documented T3151 mutation Pomalyst® Documentation
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