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​​Important changes to Pepaxto® ​coverage​

December 6, 2021

The manufacturer of Pepaxto® (melphalan flufenamide) has removed the drug from the market due to safety concerns. Based on this decision, Independence will archive Commercial and Medicare Advantage Melphalan flufenamide (Pepaxto®) policies as of January 1, 2022:

  • Commercial: #08.01.78b: Melphalan flufenamide (Pepaxto®)
  • Medicare Advantage: #MA08.135b: Melphalan flufenamide (Pepaxto®)

HCPCS code J9247 Injection, melphalan flufenamide, 1mg, will be set up as Experimental/Investigational and included in our Experimental/Investigational Services policy #12.01.01.

You can read about the decision on our commercial or Medicare Advantage Medical and Claim Payment Policy Portal or on the manufacturer's website.

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