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Draft Provider-Administered Oncology Drug Policies

Draft policies are listed below. If there are no policies listed, it means there are currently no policies in draft status.

Comment on Draft Drug Policies

Participating providers are invited to submit for consideration scientific, evidence-based information, professional consensus opinions, and other information supported by medical literature relevant to our draft policies.

We accept comments for 45 days from the posting date listed on the draft policy. 

Make sure your voice is heard by providing feedback directly to us:

  • Send comments and supporting documentation to us by mail or fax:

Blue Cross and Blue Shield of Alabama
Attn: Pharmacy Department
P.O. Box 995
Birmingham, AL 35298-0001

Fax: 205-220-9576

Draft Policies

Policy # Policy Title Print View
VP-9001 Paclitaxel Albumin-Bound: Abraxane®; Paclitaxel Albumin-Bound Ψ (Intravenous)
VP-9004 Adcetris® (brentuximab vedotin)
VP-90057 Trastuzumab: Herceptin®; Ogivri®; Kanjinti®; Trazimera™; Herzuma®; Ontruzant®
VP-9007 Pemetrexed: Alimta®; Pemfexy™; Pemetrexed Ψ (Intravenous)
VP-90136 Vectibix® (panitumumab) (Intravenous)
VP-90137 Bortezomib Velcade®; Bortezomib§
VP-9014 Bevacizumab: Avastin®; Mvasi®; Zirabev™; Alymsys®; Vegzelma™ (Intravenous)
VP-90148 Yervoy™ (ipilimumab) (Intravenous)
VP-90157 Kyprolis® (carfilzomib) (Intravenous)
VP-90184 Gazyva (obinutuzumab) (Intravenous)
VP-90200 Sylvant® (siltuximab) (Intravenous)
VP-90209 Keytruda® (pembrolizumab)
VP-90226 Opdivo® (nivolumab)
VP-90266 Darzalex™ (daratumumab) (Intravenous)
VP-90278 Tecentriq® (atezolizumab)
VP-90295 Bavencio® (avelumab) (Intravenous)
VP-90301 Imfinzi™ (durvalumab) (Intravenous)
VP-9038 Erbitux® (cetuximab) (Intravenous)
VP-90398 Libtayo® (cemiplimab-rwlc) (Intravenous)
VP-9043 Fulvestrant: Faslodex®; Fulvestrant Ψ (Intramuscular)
VP-90521 Padcev® (enfortumab vedotin-ejfv) (Intravenous)
VP-90581 Danyelza® (naxitamab-gqgk) (Intravenous)
VP-90590 Breyanzi® (lisocabtagene maraleucel)
VP-90599 Jemperli® (dostarlimab-gxly) (Intravenous)
VP-90683 Imjudo® (tremelimumab-actl) (Intravenous)
VP-90700 Zynyz™ (retifanlimab-dlwr) (Intravenous)
VP-90735 Loqtorzi™ (toripalimab-tpzi) (Intravenous)
VP-90741 Ryzneuta® (efbemalenograstim alfa-vuxw) (Subcutaneous)