Draft Provider-Administered Drug Policies (Excluding Oncology) - Blue Advantage

To ensure that the development of Blue Cross and Blue Shield of Alabama provider-administered policies occurs through an open, collaborative process, we welcome physicians and other providers to submit comments about pharmacy policies that are in the draft stage.

Note: Coverage is subject to member's specific benefits. Group specific policies will supersede these policies when applicable. Please refer to member's benefit plan.

Current Draft Policies

Draft provider-administered drug policies (excluding oncology) are listed below in alphabetical order. If there are no policies listed, then no policies are in draft status.

How to Submit Comments

We invite our participating physicians and other providers to submit scientific, evidence-based information, professional consensus opinions and other information supported by medical literature relevant to these draft policies for consideration. We receive comments for 45 days from the posting date listed on the document.

Participating providers can comment on draft policies two ways:

  1. Comment on Draft Pharmacy Policy
  2. Send comments by fax to 205-733-6471 using the Drug Policy Comments Coversheet

 

Policy #

Policy Title

PH-0002

Actemra IV (tocilizumab)

 

PH-0017

Benlysta IV (belimumab)

PH-0018

Berinert (C1 esterase inhibitor, human)

 

PH-0299

Brineura (cerliponase alfa)

PH-0028

Cimzia (certolizumab pegol)

PH-0273

Cinqair (reslizumab)

PH-0168

Cinryze (C1 esterase inhibitor human)

PH-0336

Cinvanti (aprepitant)

PH-0362 Crysvita (burosumab-twza)
PH-0202 Entyvio (vedolizumab)
PH-0358

Ilumya (tildrakizumab-asmn)

PH-0167 Kalbitor (ecallantide)
PH-0158 Krystexxa (pegloticase)
PH-0350 Luxturna (voretigene neparvovec-rzyl)
PH-0171

Makena (hydroxyprogesterone caproate)

PH-0346 Mepsevii (vestronidase alfa-vjbk)
PH-0089

Nplate ( romiplostim)

PH-260

Nucala (mepolizumab)

PH-0298

Ocrevus (ocrelizumab)

PH-0305

Radicava (edaravone)

PH-0207

Ruconest (C1 esterase inhibitor [recombinant])

PH-0176

Simponi ARIA (golimumab)

PH-0114

Soliris (eculizumab)

PH-0291

Spinraza (nusinersen)

PH-0117

Stelara (ustekinumab)

PH-0463

Sublocade (buprenorphine ER injection)

PH-0282

Testopel (testosterone pellets)

PH-0355

Trogarzo (ibalizumab-uiyk)

PH-0133

Tysabri (natalizumab)

PH-0427

Ultomiris (ravulizumab-cwvz)

PH-0139

Vivitrol (naltrexone)

PH-0145

Xiaflex (collagenase)

PH-0146

Xolair (omalizumab)