Changes to the Direct Ship Drug Program

March 25, 2021

Effective April 15, 2021, there will be changes to the availability of certain drugs through our Direct Ship Drug Program. We have expanded the program to include several enzyme replacement therapies, antineoplastic drugs, alpha-1 proteinase inhibitors, and immunological agents, as well as a variety of miscellaneous infusible therapeutics.

Additions to the program

The following 38 drugs will be added to the program:

  • Actemra® (tocilizumab)
  • Adakveo® (crizanlizumab-tmca)
  • Adcetris® (brentuximab vedotin)
  • Alimta® (pemetrexed)
  • Aralast® (alpha-1 proteinase inhibitor [human])
  • Aveed® (testosterone undecanoate)
  • Benlysta® (belimumab)
  • Cerezyme® (imiglucerase)
  • Entyvio® (vedolizumab)
  • Erbitux® (cetuximab)
  • Fabrazyme® (agalsidase beta)
  • Glassia® (alpha-1 proteinase inhibitor [human])
  • Halaven® (eribulin mesylate)
  • Invega Trinza® (paliperidone palmitate)
  • Irinotecan
  • Kadcyla® (ado-trastuzumab emtansine)
  • Krystexxa® (pegloticase)
  • Kyprolis® (carfilzomib)
  • Lemtrada® (alemtuzumab)
  • Lumizyme® (alglucosidase alfa)
  • Oncaspar® (pegaspargase)
  • Onpattro® (patisiran)
  • Opdivo® (nivolumab)
  • Orencia® (abatacept)
  • Perjeta® (pertuzumab)
  • Prolastin®-C (alpha-1 proteinase inhibitor [human])
  • Radicava® (edaravone)
  • Revcovi® (elapegademase-lvlr)
  • Simponi Aria® (golimumab)
  • Soliris® (eculizumab)
  • Tysabri® (natalizumab)
  • Valstar® (valrubicin)
  • Velcade® (bortezomib)
  • Vimizim® (elosulfase alfa)
  • VPRIV® (velaglucerase alfa)
  • Yervoy® (ipilimumab)
  • Zarxio® (filgrastim-sndz)
  • Zemaira® (alpha-1 proteinase inhibitor [human])

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

Drugs that will be removed

The following drugs will be removed from the program:

  • Alferon-N® (interferon alfa n3)
  • Macugen® (pegaptanib)
  • Neulasta® (pegfilgrastim)
  • Neupogen® (filgrastim)
  • Nivestym® (filgrastim-aafi)
  • Trelstar® (triptorelin pamoate for injectable suspension)

With the exception of Macugen, which is no longer available on the market, drugs that are being removed from the Direct Ship Drug Program are still eligible for coverage, in accordance with the coverage criteria in our medical policies. Providers must purchase these drugs from the manufacturer or a specialty pharmacy and bill Independence for reimbursement after they are administered to our members.

Learn more

The updated drug list can be found on the Direct Ship Drug Program webpage.