Starting June 1, 2022, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will begin to process clinical reviews for all non-preferred Commercial medical oncology drugs listed in the below charts in-house instead of through AIM. This change applies to non-preferred originator and biosimilar products for Commercial members with the AIM oncology program through Blue Cross NC. This follows a similar process to how our other medical drugs are reviewed at Blue Cross NC.
Also, we have removed prior authorization from all preferred medical oncology drug products (see charts below) and therefore will not do clinical reviews of these preferred products. We've updated our policies in the drug authorization search tool on the Getting Your Patient's Prescriptions Covered to reflect that change.
Preferred Bevacizumab Containing Agent(s) (Unrestricted)
- Mvasi (bevacizumab-awwb)
- Zirabev (bevacizumab-bvzr)
Non-Preferred Bevacizumab Containing Agent(s)
- Avastin (bevacizumab)
Preferred Rituximab Containing Agent(s) (Unrestricted)
- Ruxience (rituximab-pvvr)*
- Truxima (rituximab-abbs)*
Non-Preferred Rituximab Containing Agent(s) (Unrestricted)
- Rituxan (rituximab)
- Riabni (rituximab-arrx)
Preferred Trastuzumab Containing Agent(s) (Unrestricted)
- Kanjinti (trastuzumab-anns)
- Ogivri (trastuzumab-dkst)
Non-Preferred Trastuzumab Containing Agent(s)
- Herceptin (trastuzumab)
- Herzuma (trastuzumab-pkrb)
- Ontruzant (trastuzumab-dttb)
- Trazimera (trastuzumab-qyyp)
Preferred Filgrastim Products (Unrestricted)
- Nivestym (filgrastim)
- Zarxio (filgrastim-sndz)
Non-Preferred Filgrastim Products
- Granix (tbo-filgrastim)
- Neupogen (filgrastim)
- Releuko (filgrastim)
Preferred Pegfilgrastim Products (Unrestricted)
- Udenyca (pegfilgrastim-cbqv)
- Ziextenzo (pegfilgrastim-bmez)
Non- Preferred Pegfilgrastim Products
- Fulphila (pegfilgrastim-jmdb)
- Neulasta, Neulasta OnPro (pegfilgrastim)
- Nyvepria (pegfilgrastim-apgf)
*Indicated products may still require review for non-oncology related indications, please refer to Getting Your Patient's Prescription Drugs Covered page for more information.
Providers requesting prior authorization for a non-preferred product on or after June 1, 2022, for an applicable Commercial member will need to submit the request through CoverMyMeds instead of through the AIM portal. No action is needed prior to June 1.
AIM will continue to conduct clinical reviews for all other drugs in the AIM medical oncology program.
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
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