Aetna Issues Changes to National Precertification List

October 2019 ~

Aetna has released the latest updates to its National Precertification List (NPL), including updates to new-to-market drugs and site of care requirements. These changes are as follows.

New-to-market drugs requiring precertification:

  • UltomirisTM (ravulizumab-cwvz) – precertification for both the drug and the site of care effective March 15, 2019.
  • Mavenclad® (cladribine) – precertification effective May 15, 2019. This drug is included in the multiple sclerosis drug class.
  • Mayzent® (siponimod) – precertification effective May 15, 2019. This drug is included in the multiple sclerosis drug class.
  • SpravatoTM (esketamine) – precertification effective May 15, 2019.
  • Zolgensma® (onasemnogene abeparvovec-xioi) – precertification for both the drug and the site of care effective July 1, 2019.

Effective August 1, 2019, precertification is required for both the drug and the site of care for the following drugs:

  • Cutaquig®(IVIG).

Effective January 1, 2020, precertification is required for both the drug and the site of care for the following drugs:

  • Cinryze® (C1 esterase inhibitor)
  • Aralast® NP (alpha 1-proteinase inhibitor)
  • GlassiaTM (alpha 1-proteinase inhibitor)
  • Prolastin®-C (alpha 1-proteinase inhibitor)
  • Zemaira® (alpha 1-proteinase inhibitor)
  • Aldurazyme® (laronidase)
  • Cerezyme® (imiglucerase)
  • Elaprase® (idursulfase)
  • Elelyso® (taliglucerase alfa)
  • Fabrazyme® (agalsidase beta)
  • Kanuma® (sebelipase alfa)
  • Lumizyme® (alglucosidase alfa)
  • MepseviiTM (vestronidase alfa-vjbk)
  • Naglazyme® (galsulfase)
  • Vimizim® (elosulfase alfa)
  • VPRIV® (velaglucerase alfa)

Effective January 1, 2020, the following drugs will no longer require precertification:

  • Krystexxa® (pegloticase)
  • Gazyva® (obinutuzumab)

More information about precertification can be found under the General Information section of the NPL.

 

 

Source(s): Aetna;

 

 

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