​Effective September 1, 2022, the Independence Blue Cross (Independence) Dosage and Frequency Program will expand to include 15 new drugs.

The following drugs will be added to this program:

• Adakveo^® (crizanlizumab-tmca)
• Alymsys^® (bevacizumab-maly)
• Amvuttra™ (vutrisiran)
• Avsola™ (infliximab-axxq)
• Enhertu^® (fam-trastuzumab-deruxtecan-nxki)
• Evkeeza™ (evinacumab-dgnb)
• Givlaari^® (givosiran)
• Infliximab (unbranded)
• Nexviazyme^® (avalglucosidase alfa-ngpt)
• Oxlumo^® (lumasiran)
• Padcev^® (enfortumab vedotin-ejfv)
• Reblozyl^® (luspatercept-aamt)
• Tepezza^® (teprotumumab-trbw)
  
• Trodelvy^® (sacituzumab govitecan-hziy)
• Uplizna^® (inebilizumab-cdon)
  

The following drugs will be removed from this program:

• Adagen^® (pegademase bovine)
• Carimune NF^® (nanofiltered, immune globulin, intravenous [human])
• Rituxan^® (rituximab)
• Rituxan Hycela^® (rituximab/hyaluronidase [human])
• Ruxience^® (rituximab-pvvr)
• Truxima^® (rituximab-abbs)

Adagen and Carimune NF have been removed from the program because they are no longer available in the U.S. market. The rituximab-based drugs (Rituxan, Rituxan Hycela, Ruxience, and Truxima) have been removed from the program but will continue to be eligible for coverage under the medical benefit for members who meet the medical necessity criteria in our medical policy.

Learn more

During the precertification process, Independence ensures that the requested regimen for any drug on this program will be administered in accordance with the dosage and frequency approved by the U.S. Food and Drug Administration (FDA) or company-recognized compendia. For more information on each drug's dosage and frequency guidelines, please refer to the medical policy for the specific drug. To access these policies, visit our Medical Policy Portal.

Resources

For more information, including the complete list of all 80 drugs on this program, visit our Dosage & Frequency Program webpages:

Independence Blue Cross

Independence Administrators​