Anthem removes drugs from specialty pharmacy clinical site of care (level of care) drug list

Effective immediately, the following specialty pharmacy codes from new or current coverage guidelines will be removed from our existing specialty pharmacy clinical site of care review process.

 

Please note, these drugs will continue to require pre-service clinical review for medical necessity.

Coverage or Clinical Guideline	Drug	Code
CG-DRUG-100	Actimmune®	J9216
DRUG.00086	Increlex®	J2170
CG-DRUG-60	Firmagon®	J9155