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Notification of Commercial Drug Policy Revisions Effective March 29, 2024

Medical Drug Policy Name

Revised Criteria

Antiemetic Injection Therapy NotificationAdded newly approved Focinvez (fosaprepitant) to policy, and associated dosing and HCPCS codes C9399, J3490, J3590, and J9999 to FDA label reference table. Adjusted trial and failure requirements for Cinvanti to require trial of Emend (fosaprepitant), and trial of granisetron or ondansetron for low to minimally emetogenic cancer chemotherapy regimens. Adjusted indication for Emend per FDA label to include pediatric patients 6 months of age or older weighing at least 6 kg. Updated NCCN Emetogenic Potential of Intravenous and Oral Antineoplastic Agents tables. Medical policy formatting change. Policy notification given 1/29/2024 for effective date 3/29/2024.

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