Home Administrative Billing & Reimbursement Health and Wellness Medical PEAR portal Pharmacy Products Quality Management

​​Changes to the Direct Ship Drug Program

June 20, 2022

As of June 15, 2022, AmeriHealth expanded the Direct Ship Drug Program to include more than 100 injectable and infusion drugs eligible for coverage under the medical benefit. In-network providers can order any drug on this program at no cost.

Additions to the program

The following drugs will be added to the program:

  • Apretude™ (cabotegravir)
  • Cabenuva™ (cabotegravir/rilpivirine)
  • Fensolvi® (leuprolide acetate)
  • Ilumya® (tildrakizumab-asmn)
  • Inflectra® (infliximab-dyyb)
  • Infliximab
  • Invega Hafyera™ (paliperidone palmitate)
  • Leqvio® (inclisiran)
  • Nexviazyme® (avalglucosidase alfa-ngpt)
  • Ocrevus® (ocrelizumab)
  • Perseris® (risperidone)
  • Phesgo® (pertuzumab, trastuzumab, and hyaluronidase-zzxf)
  • Spravato® (esketamine)
  • Tezspire™ (tezepelumab-ekko)
  • Ultomiris® (ravulizumab-cwvz)
  • Vabysmo® (faricimab-svoa)
  • Vyepti® (eptinezumab-jjmr)
  • Ziextenzo® (pegfilgrastim-bmez)​

As a reminder, all drugs available through the Direct Ship Drug Program are subject to precertification review, even if they are not published on the precertification list.

Drug that will be removed

The following drug will be removed from the program:

  • Vimizim® (elosulfase alfa)

Vimizim is still eligible for coverage, in accordance with the medical necessity criteria in our medical policy. However, providers must now purchase this drug from the manufacturer or a specialty pharmacy and bill AmeriHealth for reimbursement after it is administered to members.

Learn more

The updated drug list can be found on our Direct Ship Drug Program webpages:


This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of AmeriHealth, AmeriHealth HMO, Inc., AmeriHealth Insurance Company of New Jersey.
© 2023 AmeriHealth Site Map        Anti-Fraud        Privacy Policy        Legal        Disclaimer