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Pharmacy Medical Policy Updates

The following Pharmacy Medical Policy programs were updated Dec. 1, 2024:

Effective Jan. 1, 2025:

  • Biologic Immunomodulators
  • Efgartigimod
  • Empaveli
  • Enspryng
  • Fabhalta
  • Filsuvez
  • HCPA MS
  • Hereditary Angioedema
  • Niktivmo
  • Parathyroid Hormone Analog for Osteoporosis
  • PCSK9
  • Peanut Allergy
  • Rystiggo
  • Rytelo
  • SA Oncology
  • Soliris and Ultomiris
  • Topical Estrogen
  • Voydeya
  • Vyjuvek
  • Zepsosia
  • Zilbrysq

Many of our pharmacy medical policies are maintained through our pharmacy benefit manager, Prime Therapeutics.

To find pharmacy medical policies specific to a medication list, please select a medication list at the bottom of our prior authorization page of our website, https://www.bcbsks.com/providers/precertification-prior-authorization

If you have any questions regarding this newsletter, please contact your BCBSKS provider representative/consultant.

Institutional Providers
Professional Providers