Effective July 1, 2026, Independence Blue Cross (IBX) and Independence Administrators are updating the list of specialty drugs that require precertification under the medical benefit for members enrolled in plans administered by Independence Administrators and IBX Commercial and Medicare Advantage HMO and PPO plans.
Additions
The following drugs have recently been approved by the FDA and will require precertification:
- Lunsumio Velo™ (mosunetuzumab-axgb) – Antineoplastic agents
- Rybrevant Faspro® (amivantamab-hyaluraonidase-lpuj) – Antineoplastic agents
- Boncresa® (denosumab-mobz) – Bone-modifying agents
- Oziltus® (denosumab-mobz) – Bone-modifying agents
- Ponlimsi® (denosumab-adet) – Bone-modifying agents
- Fesilty™ (fibrinogen, human-chmt) – Coagulation factors
- Avlayah™ (tividenofusp alfa-eknm) – Enzyme replacement agents
- Loargys® (pegzilarginase-nbln) – Enzyme replacement agents
- Kresladi™ (marnetegragene autotemcel) – Gene replacement/gene editing therapies
- Otarmeni™ (lunsotogene parvec-cwha, formerly known as DB-OTO) – Gene replacement/gene editing therapies
- Waskyra™ (etuvetidigene autotemcel) – Gene replacement/gene editing therapies
- Immgolis® (golimumab-sldi) – Immunological agent
- Yartemlea® (narsoplimab) – Miscellaneous therapeutic agents
- Armlupeg® (pegfilgrastim-unne) – Neutropenia
- Filkri™ (filgrastim-laha) – Neutropenia
- Nufymco® (ranibizumab-leyk) – Ophthalmic agents
- Exdensur® (depemokimab-ulaa) – Respiratory agents
The following drugs are pending FDA approval and will require precertification as of the date they receive FDA approval:
- 177Lu-edotreotide – Endocrine/metabolic agents
- Dalnacogene ponparvovec – Gene replacement/gene editing therapies
- Pariglasgene brecaparvovec – Gene replacement/gene editing therapies
- Garetosmab – Miscellaneous therapeutic agents
- Pegadricase – Miscellaneous therapeutic agents
- Veligrotug – Ophthalmic agents
- Orca-T – TIL and T Cell therapies
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