Final Hemophilia Drug Policies

Drug policies are based on:

• information in FDA-approved package inserts (and black box warnings, alerts or other information disseminated by the FDA, as applicable);
• research of current medical and pharmacy literature; and/or,
• review of common medical practices in the treatment and diagnosis of disease.

Final and draft policies are published on this site. Draft policies are available for provider review for 45 days from the posting date on the policy. 

Note: Coverage is subject to the member's specific benefits. Group-specific benefits will supersede these policies when applicable. Always check eligibility and benefits through your local Blue Plan provider portal or your practice management system to confirm member-specific benefits. 

Prime Therapeutics Hemophilia Management services will be used to perform utilization management and oversight of specialty pharmacy dispensing as part of the Hemophilia Drug Prior Authorization Program. 
 
For groups that have their pharmacy benefits carved in and participate in utilization management, Prime Therapeutics will perform the prior authorization (PA) drug reviews. The PA reviews will ensure that optimal products and dosing are being prescribed. Hemophilia products will be billed as self-administered products under the member's pharmacy benefit.

Use the navigation on the left or search function above to locate specific drug policy information.

Pharmacy drug policies provide a guide to coverage. Pharmacy policies are not intended to dictate to providers how to practice medicine. Providers should exercise their medical judgment in providing the care they feel is most appropriate for their patients.