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Pharmacy Medical Policy Updates

The following Pharmacy Medical Policy programs will be updated Feb. 1, 2025:

Effective March 1, 2025:

  • Biologic Immunomodulators
  • Cibinqo
  • HCPA Biologics
  • Healthcare Administered MS
  • IL-4 inhibitors
  • IL-5 inhibitors
  • IL-13 inhibitors
  • Multiple Sclerosis
  • Nasal Inhalers
  • Niemann-Pick Type C Agents
  • Sohonos
  • Tezspire
  • Tryvio
  • Weight Management
  • Xolair
  • Yorvipath
  • Zeposia

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