Aetna Commercial Drug List Changes Begin on January 1

November 2018 ~

On January 1, Aetna will make updates to certain products on its pharmacy plan drug lists, including such products as granulocyte colony-stimulating factor (G-CSF) and epoetin alfa products.

Updates for Granulocyte Colony-Stimulating Factor (G-CSF) Products

  • As of January 1, 2019, FulphilaTM (pegfilgrastim-jmdb) will be considered the least costly long-acting G-CSF product.
  • All G-CSFs will remain on the National Precertification List and require precertification.
  • Coverage for Neulasta® will require a trial of FulphilaTM
    • They will also need to meet the clinical precertification criteria. Zarxio® will remain the insurer’s least costly short-acting G-CSF product.

Updates for Epoetin Alfa Products

  • As of January 1, 2019, RetacritTM (epoetin alfa-epbx) will be considered the least costly epoetin alfa product.
  • All epoetin alfa products will remain on the National Precertification List and require precertification.
  • Coverage for Procrit® and Epogen® will require a trial of RetacritTM.
    • They will also need to meet the clinical precertification criteria. Aranesp® will not be affected by this change.

A complete list of upcoming formularies, pharmacy clinical policy and standard plan changes can be accessed on Aetna’s Formularies & Pharmacy Clinical Policy Bulletins page.

 

 

Source(s): Aetna OfficeLink Updates, All Regions, September 2018;

 

 

 

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