[

---

Attention! There is an updated version of this communication, Updates to the list of specialty drugs that will require precertification.

---

Effective January 1, 2018, AmeriHealth will make the changes detailed bellow to specialty drugs requiring precertification.

New precertification requirements will apply to AmeriHealth members for the following specialty drugs that are covered under the medical benefit:

1. Emend^® for injection (fosaprepitant)
2. Radicava^™ (edaravone)
3. Somatuline^® Depot (lanreotide)
4. Sustol^® (granisetron extended release)

In addition, the following drugs are currently pending approval from the U.S. Food and Drug Administration (FDA). Once they receive FDA approval, these drugs will also require precertification from AmeriHealth:

• Avastin^® (bevacizumab) biosimilar
• Axicabtagene ciloleucel
• Cinvanti^™ (aprepitant)
• Exenatide sustained-release ITCA 650
• Herceptin^® (trastuzumab) biosimilar
• Luxturna^™ (voretigene neparvovec)
• Neulasta^® (pegfilgrastim) biosimilar
• Varubi^® (rolapitant)

The following drugs will no longer require precertification from AmeriHealth as of January 1, 2018:

• Berinert^® (C1 esterase inhibitor [human])*
• Cinryze^® (C1 esterase inhibitor [human])*
• Cubicin^® (daptomycin)
• Kalbitor^® (ecallantide)
• Myozyme^® (alglocosidase alfa)
• Ruconest^® (C1 esterase inhibitor recombinant)*
• Synribo^® (omacetaxine mepesuccinate)

These changes will be reflected in an updated precertification requirement list, which will be available on the AmeriHealth New Jersey and AmeriHealth Pennsylvania later this year, prior to these changes going into effect. The availability of the updated precertification requirement list will be announced in a future Partners in Health Update^SM article.

*Effective January 1, 2018, these drugs will no longer be eligible for coverage under the medical benefit. As self-administered drugs, they will now be eligible for coverage under the pharmacy benefit for members with coverage through FutureScripts^®. For members who do not have coverage through FutureScripts, they should contact their pharmacy benefits manager to determine if coverage for these self-administered drugs is available.

]