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Notification/Prior Authorization Required for New Specialty Medications

February 7, 2017

Effective Jan. 1, 2017, UnitedHealthcare requires notification for the following new specialty medications:

  • Probuphine (buprenorphine) subdermal implants are indicated for the maintenance treatment of opioid dependence in patients who have achieved and sustained prolonged clinical stability on low to moderate doses of a transmucosal buprenorphine-containing product (i.e., doses of no more than 8 mg per day of buprenorphine sublingual tablet equivalent).
  • Cinqair® (reslizumab) and Nucala® (mepolizumab) are indicated for the add-on maintenance treatment of patients with severe asthma who have an eosinophilic phenotype. 
  • Ocrevus™ (ocrelizumab) is anticipated to be indicated for the treatment of primary progressive multiple sclerosis and relapsing/remitting multiple sclerosis. This drug is currently being reviewed by the U.S. Food and Drug Administration (FDA), and a decision is expected by the end of March. Prior notification will be required upon FDA approval.
  • Gonadotropin-releasing hormone analogs are indicated for the suppression of puberty in adolescents diagnosed with gender dysphoria. This new policy refers to the following GnRH Analog drug products:
    • Firmagon® (degarelix)
    • Lupron Depot® (leuprolide acetate)
    • Lupron Depot-Ped® (leuprolide acetate)
    • Supprelin® LA (histrelin acetate)
    • Trelstar® (triptorelin pamoate)
    • Vantas® (histrelin acetate)
    • Zoladex® (goserelin acetate)

For more information, visit UnitedHealthcare’s Specialty Pharmacy Information Center or contact your UnitedHealthcare representative.