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

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Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield of Wisconsin (BCBSWI), Compcare Health Services Insurance Corporation (Compcare), and Wisconsin Collaborative Insurance Company (WCIC). BCBSWI underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensee(s) 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