Medicare AdvantageJanuary 31, 2024
Notification of specialty pharmacy medical step therapy updates
This is a courtesy notice as there is no change to current status of Eylea HD in the Medical Step Therapy Program. The step criteria for anti-vascular endothelial growth factor (VEGF) inhibitors found in Clinical Criteria document CC-0072 will formally list Eylea HD as a preferred product.
Clinical UM Guidelines are publicly available on the provider website. Visit the Clinical Criteria page to search for specific criteria.
Clinical UM Guidelines | Preferred drug(s) | Nonpreferred drug(s) |
CC-0072 | Avastin Byooviz Cimerli Eylea Eylea HD Lucentis Vabysmo | Beovu Macugen |
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In Missouri (excluding 30 counties in the Kansas City area): Anthem Blue Cross and Blue Shield is the trade name of RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
MULTI-BCBS-CR-046817-23-CPN45766
PUBLICATIONS: March 2024 Provider Newsletter
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