Dean Health Plan Medical Policy Updates – September 2018

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September 2018 Dean Health Plan Medical Policy Updates:

• 2018 Pharmacy Directory
• ACTEMRA (tocilizumab) – IV FORMULATION
• ACTEMRA (tocilizumab) – SQ FORMULATION
• ALDURAZYME (laronidase)
• ALECENSA (alectinib)
• AVASTIN (bevacizumab)
• Bariatric Surgery
• BOSULIF (bosutinib)
• Breast Pumps, Hospital Grade
• COSENTYX (secukinumab)
• COTELLIC (cobimetinib)/ZELBORAF (vemurafenib)
• Enteral Therapy
• FABRAZYME (agalsidase)
• Gastric Pacemaker and Gastric Electrical Stimulation
• Genetic Testing
• Genetic Testing for Pharmacogenetics
• GLEEVEC (imatinib)
• HYCAMTIN (topotecan)
• Inflammatory Bowel Disease: Serologic Markers and Pharmacogenomic and Metabolic Assessment of Thiopurine Therapy
• Intensity Modulated Radiation Therapy (IMRT)
• Intrathecal Pump Implantation
• Knee Procedures
• Liver and Other Neoplasm – Chemoembolization (CE) and Intra-Hepatic Microspheres (TheraSphere)
• Lymphedema Compression Devices
• Mechanical Stretching Devices for Contracture and Joint Stiffness
• Neuropsychological Testing
• NEXAVAR (sorafenib)
• NINLARO (ixazomib)
• NUVIGIL (armodafanil)
• OCREVUS (ocrelizumab)
• ONFI (clobazam)
• OZURDEX (dexamethasone intravitreal implant) J7312
• Percutaneous Left Atrial Appendage (LAA) Closure Therapy
• PERJETA (pertuzumab)
• PROLIA, XGEVA (denosumab)
• PROVIGIL (modafinil)
• Responsive Nerve Stimulation
• RUBRACA (rucaparib)
• Sacroiliac (SI) Joint Injections
• SOLIRIS (eculizumab) J1300
• Spinal Cord or Dorsal Column Stimulation
• SPRYCEL (dasatinib)
• Stereotactic Body Radiotherapy
• STIVARGA (regorafenib)
• STRENSIQ (asfotase alfa)
• SUTENT (sunitinib)
• TAGRISSO (osimertinib)
• TARGRETIN GEL (bexarotene gel)
• TASIGNA (nilotinib)
• THALOMID (thalidomide)
• Topical Steroids – TEMOVATE (clobetasol propionate gel ), CLOBEX (clobetasol shampoo, spray, lotion)
• Traction for Cervical and Lumbar Pain
• Treatment of Obstructive Sleep Apnea (OSA)
• TYKERB (lapatinib)
• VIVITROL (naltrexone extended release injection
• VOTRIENT (pazopanib)
• XTANDI (enzalutamide)
• ZOLINZA (vorinostat)
• ZORTRESS (everolimus)
• ZYTIGA (abiraterone)

Click here to view the Dean Health Plan Medical Policy Updates »

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