On October 2, 2017, Independence notified providers that requests for certain chemotherapy-induced nausea and vomiting (CINV) agents will require precertification as of January 1, 2018. Based on valuable feedback from our prescribing provider community, Independence has decided that precertification approval will only be required for Sustol® (granisetron extended release). Therefore, the drugs Emend® for injection (fosaprepitant), Varubi® (rolapitant), and CinvantiTM (aprepitant) will not require precertification approval, as previously communicated.
Effective January 1, 2018, the specialty drug Sustol will require precertification approval for all Independence members. Requests for members to receive Sustol on or after January 1, 2018, must be preapproved by Independence, in accordance with the coverage criteria listed in the applicable Independence policies. 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 the following Independence policies, which were updated to reflect these changes and will become effective January 1, 2018:
- Commercial: #08.01.41: Fosaprepitant Dimeglumine (Emend®), Granisetron (Sustol®), and Rolapitant (Varubi®)
- Medicare Advantage: #MA08.091: Fosaprepitant Dimeglumine (Emend®), Granisetron (Sustol®), and Rolapitant (Varubi®)
To view the Notifications for these policies, visit our
Medical Policy Portal. Select
Accept and Go to Medical Policy Online, and then select
Commercial or
Medicare Advantage under Active Notifications. Please note that as the new CINV agents come to market, these policies will be updated accordingly.