Aetna National Precertification List Updates

September 2019 ~

Aetna has released the latest updates to its National Precertification List (NPL), scheduled to take effect this year through January 2020.

New-To-Market Drugs Requiring Precertification

  • Effective Date: March 15, 2019
    • UltomirisTM(ravulizumab-cwvz) – precertification for both the drug and the site of care.
  • Effective Date: May 15, 2019
    • Mavenclad®(cladribine) – This drug is included in the multiple sclerosis drug class.
    • Mayzent®(siponimod) – This drug is included in the multiple sclerosis drug class.
    • SpravatoTM(esketamine)
    • Zolgensma®(onasemnogene abeparvovec-xioi) – precertification for both the drug and the site of care.
  • Effective Date: July 1, 2019
    • Evenity®(romosozumab-aqqg)
    • SkyriziTM(risankizumab-rzaa)
    • Herceptin HylectaTM(trastuzumab and hyaluronidase-oysk)
  • Effective Date: August 1, 2019
    • Cutaquig®(IVIG) – for both the drug and site of care.
  • Effective Date: January 1, 2020, for both the drug and the site of care
    • 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)

No Longer Requiring Precertification

  • Effective Date: January 1, 2020
    • Krystexxa®(pegloticase)
    • Gazyva®(obinutuzumab)

For more information about Aetna’s precertification changes, refer to the payer’s NPL under the General Information section.

Source(s): Aetna Office Link Updates;

 

 

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