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UHC New Specialty Medication Requirements

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All, UHC

Notification/Prior Authorization Required for New Specialty Medications

  • ​​Probuphine (buprenorphine) subdermal implants are indicated for the maintenance treatment of opioid dependence in patients who have achieved and sustained prolonged clinical stability on low to moderate doses of a transmucosal buprenorphine-containing product (i.e., doses of no more than 8 mg per day of buprenorphine sublingual tablet equivalent). 
  • Cinqair® (reslizumab) and Nucala® (mepolizumab) are indicated for the add-on maintenance treatment of patients with severe asthma who have an eosinophilic phenotype.
  • Ocrevus™ (ocrelizumab) is anticipated to be indicated for the treatment of primary progressive multiple sclerosis and relapsing/remitting multiple sclerosis. This drug is currently being reviewed by the U.S. Food and Drug Administration (FDA), and a decision is expected by the end of March. Prior notification will be required upon FDA approval. 
  • Gonadotropin-releasing hormone analogs are indicated for the suppression of puberty in adolescents diagnosed with gender dysphoria. This new policy refers to the following GnRH Analog drug products: 
    • Firmagon® (degarelix) 
    • Lupron Depot® (leuprolide acetate) 
    • Lupron Depot-Ped® (leuprolide acetate) 
    • Supprelin® LA (histrelin acetate)
    • Trelstar® (triptorelin pamoate) 
    • Vantas® (histrelin acetate) 
    • Zoladex® (goserelin acetate)

For questions, please ​contact a member of your B&P Sales Team - 888.722.3373.