Commercial Medical Drug Prior Authorization Program adds Ilumya™

Starting Aug. 1, 2018, Ilumya (tildrakizumab-asmn) will be part of the Blue Cross Blue Shield of Michigan commercial Medical Drug Prior Authorization Program.

You can find information about the program by logging in to web-DENIS, clicking on BCBSM Provider Publications and Resources, and selecting Newsletters and Resources. Click Forms (under Other Resources), then Physician administered medications.

Keep in mind that the prior authorization requirement doesn’t apply to Federal Employee Program^® members.

The list below reflects all the medications in the program as of Aug. 1:

Drug names
Actemra^®	Elaprase^®	Kalbitor^®	Remicade^®
Acthar^® gel	Elelyso™	Kanuma™	Ruconest^®
Adagen^®	Entyvio™	Krystexxa^®	Signifor^® LAR
Aldurazyme^®	Exondys 51™	Lemtrada™	Simponi Aria^®
Aralast NP™	Fabrazyme^®	Lumizyme^®	Soliris^®
Aveed^®	Fasenra™	Luxturna™	Spinraza™
Benlysta^®	Firazyr^®	Makena^®	Stelara^®
Berinert^®	Flebogamma^® DIF	Mepsevii™	Stelara IV^®
Bivigam™	Gammagard Liquid^®	Myobloc^®	Synagis^®
Botox^®	Gammagard^® S/D	Myozyme^®	Testopel^®
Brineura™	Gammaked^®	Naglazyme^®	Tysabri^®
Carimune^® NF	Gammaplex^®	Nplate^®	Vimizim™
Cerezyme^®	Gamunex^®	Nucala^®	Vpriv^®
Cimzia^®	Glassia™	Ocrevus™	Xeomin^®
Cinqair^®	Hizentra^®	Octagam^®	Xgeva^®
Cinryze^®	HyQvia^®	Orencia^®	Xiaflex^®
Cosentyx™	Ilaris^®	Privigen^®	Xolair^®
Crysvita^®	Ilumya™	Prolastin^®-C	Yescarta^®
Cuvitru^®	Immune globulin	Prolia^®	Zemaira^®
Dysport^®	Inflectra™	Radicava™	Zinplava™

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2017 American Medical Association. All rights reserved.