On October 2, 2017, AmeriHealth notified providers that requests for certain chemotherapy-induced nausea and vomiting (CINV) agents will require precertification as of January 1, 2018. Based on feedback from our prescribing provider community, AmeriHealth has decided that precertification approval will only be required for Sustol^® (granisetron extended release). Therefore, the drugs Emend^® for injection (fosaprepitant), Varubi^® (rolapitant), and Cinvanti^TM (aprepitant) will not require precertification approval, as previously communicated.

Effective January 1, 2018, the specialty drug Sustol will require precertification approval for all AmeriHealth members. Requests for members to receive Sustol on or after January 1, 2018, must be preapproved by AmeriHealth, in accordance with the coverage criteria listed in the applicable AmeriHealth medical policy. This requirement applies to members who are currently receiving Sustol as well as members who begin treatment with this drug on or after January 1, 2018.

For more information

To learn more, please refer to Medical Policy #08.01.41: Fosaprepitant Dimeglumine (Emend^®), Granisetron (Sustol^®), and Rolapitant (Varubi^®), which was updated to reflect these changes and will become effective January 1, 2018.

To view the Notification for this policy, visit our Medical Policy Portal. Select Accept and Go to Medical Policy Online, and then select Commercial under Active Notifications. Please note that as the new CINV agents come to market, this policy will be updated accordingly.