Article correction: Announcing changes to preferred drug designations under medical benefits for most members

In the November 2024 Record, we published an article with an incorrect drug name. One of the preferred drugs for commercial members for pegfilgrastim is Udenyca Onbody™, not Udenyca OnPro™. We’ve updated the article below with the correct information.

For dates of service on or after Jan. 1, 2025, Blue Cross Blue Shield of Michigan and Blue Care Network are making changes to preferred drug designations for some drugs. In addition, health care providers will need to submit prior authorization requests through different systems for some preferred and nonpreferred drugs.

These changes will affect:

• Blue Cross Blue Shield of Michigan commercial members

  Exception: These changes don’t apply to UAW Retiree Medical Benefits Trust non-Medicare members or Blue Cross and Blue Shield Federal Employee Program^® members.

• Medicare Plus Blue℠ members
• BCN commercial members
• BCN Advantage℠ members

Changes to preferred drug designations

The following table shows how we’re changing preferred drug designations. Changes are in bold text.

How existing prior authorizations are affected by these changes

• For commercial members with Neulasta or Neulasta OnPro authorizations: Members can continue with therapy until their authorization expires. Upon renewal, providers will be directed to use a preferred product.
• For commercial and Medicare Advantage members receiving Truxima: We encourage providers to transition members to a preferred drug for dates of service on or after Jan. 1, 2025. Preferred rituximab products don’t require authorization.

Changes to prior authorization processes

The following table outlines prior authorization requirements for the drugs listed above for dates of service on or after Jan. 1, 2025.

Note: To determine which Blue Cross and BCN commercial groups participate in the Oncology Value Management program through OncoHealth® for dates of service on or after Jan. 1, 2025, see this list.

Additional information

See the “Find out which medical benefit oncology drugs will require prior authorization through OncoHealth, starting Jan. 1” article for more details about drugs that will have requirements through the Oncology Value Management program for dates of service on or after Jan. 1, 2025.

For additional information about medical benefit drugs, read these pages of our ereferrals.bcbsm.com website:

• Blue Cross Medical Benefit Drugs
• BCN Medical Benefit Drugs

OncoHealth is an independent company supporting Blue Cross Blue Shield of Michigan and Blue Care Network by providing cancer support services.