Starting July 1, 2020, ConnectiCare has selected preferred products for all lines of business for bevacizumab, trastuzumab and rituximab.
Members who received authorization prior to July 1, 2020 may continue treatment with the non-preferred drugs listed below. Non-Medicare Advantage members who start therapy on or after July 1, 2020 must have a trial and therapeutic failure of a preferred alternative drug prior to approval of a non-preferred drug.
| Chemical name | Non-preferred drug(s) |
Preferred alternative drug(s) |
|---|---|---|
| bevacizumab | Avastin (J9035)3 | Mvasi (Q5107) Zirabev (Q5118) |
| trastuzumab | Herceptin (J9355) Herzuma (Q5113) Ontruzant (Q5112) |
Kanjinti (Q5117) Ogivri (Q5114) Trazimera (Q5116) |
| rituximab | Rituxan (J9312) | Ruxience (J9999) Truxima (Q5115) |
3Oncology indications only.
Preferred products also require preauthorization.
Below are our medical policies related to this update. Please note, these EmblemHealth policies apply to ConnectiCare. ConnectiCare and its affiliates are members of the EmblemHealth family of companies.
