Pharmacy Medical Policy Updates
Pharmacy Medical Policy Updates
The following Pharmacy Medical Policy programs were updated July 15, 2025:
Effective Aug. 15, 2025:
| Abecma | Entyvio IV | Lumizyme | SCIG |
| Adakveo | Epkinly | Lunsumio | Simponi Aria |
| Adcetris | Epoetin alfa | Lymphir | Skyrizi IV |
| Adstiladrin | Erbitux | Margenza | Spevigo IV |
| Adzynma | Evenity | Mepsevii | Spevigo SQ |
| Aflibercept | Evkeez | Monjuvi | Spinraza |
| Akynzeo IV | Fabrazyme | Monoferric | Sustol |
| Aldurazyme | Factor IX | Naglazyme | Susvimo |
| Alhemo | Factor VIIa | Natalizumab | Syfovre |
| Alpha-1-Proteinase Inhibitors | Factor VIII | Nexviazyme | Synagis |
| Amtagvi | Factor VIII-VWF | Niktimvo | Takhyzro |
| Amvuttra | Factor X | Nplate | Talvey |
| Anktiva | Factor XIII | Nucala | Tecartus |
| Anti-Inhibitor Antibody | Factor XIIIA | Ocrevus IV | Tecelra |
| Anti-Inhibitor Coagulant Complex | Fasenra | Ocrevus SQ | Tecentriq IV |
| Anti-Inhibitor_Ab | Firazyr | Omisirge | Tecentriq SQ |
| Aranesp | Fyarro | Omvoh | Tecvayli |
| Aucatzyl | Gamifant | Oncaspar | Tepezza |
| Bavencio | Gazyva | Onivyde | Tevimbra |
| Bendamustine | GCSF-long acting | Onpattro | Tezspire |
| Benlysta | GCSF-short acting | Opdivo | Tivdak |
| Beovu | Givlaari | Opdivo SQ | Tocilizumab IV |
| Berinert | Haegarda | Opdualag | Trastuzumab IV |
| Bevacizumab_ONCO | Halaven | Orencia | Trastuzumab SQ |
| Bevacizumab_Oncology | Hympavzi | Oxlumo | Tremfya |
| Bizengri | Hympavzi | Paclitaxel Albumin-Bound | Trodelvy |
| Blincyto | Ilaris | Padcev | Ultomiris |
| Breyanzi | Ilumya | Penpulimab-KCQX | Unloxcyt |
| Briumvi | Imaavy | Perjeta | Uplizna |
| Cabazitaxel | Imdelltra | Phesgo | Ustekinumab |
| Carvykti | Imfinzi | Piasky | Vabysmo |
| Cimzia | Imjudo | Polivy | Vectibix |
| Cinqair | Infliximabs | Pombiliti | Veopoz |
| Cinryze | Injectafer | Poteligeo | Vimizim |
| Columvi | IVIG | Provenge | Von Willebrand Factor |
| Cosentyx | Izervay | Qalsody | VPRIV |
| Crysvita | Jelmyto | Qfitlia | VWF |
| Danyelza | Jemperli | Ranibizumab | Vyepti |
| Darzalex IV | Kadcyla | Reblozyl | Vyloy |
| Darzalex SQ | Kalbitor | Revcovi | Vyvgart IV |
| Datroway | Kanuma | Rituximab IV | Vyvgart SQ |
| Denosumab | Keytruda | Rituximab SQ | Xenpozyme |
| Eculizumab | Kimmtrak | Rivfloza | Xolair |
| Elahere | Krystexxa | Romidepsin | Yervoy |
| Elaprase | Kymriah | Ruconest | Yescarta |
| Elelyso | Kyprolis | Rybrevant | Yondelis |
| Elfabrio | Lamzede | Rylaze | Zaltrap |
| Elrexfio | Lemtrada | Ryplazim | Zepzelca |
| Elzonris | Leqembi | Rystiggo | Ziihera |
| Empaveli | Leqvio | Rytelo | Zilretta |
| Enhertu | Levoleucovorin | Saphnelo | Zynlonta |
| Enjaymo | Libtayo | Sarclisa | Zynyz |
| Enspryng | Loqtorzi | Scenesse |
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.
If you have any questions please contact your BCBSKS provider relations representative.