Products & Programs PharmacyMedicare 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

Through genuine collaboration, we can simplify access to care and help you deliver high-quality, equitable healthcare.

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