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Changes to Our Self-Injectable Drugs Policy

Effective January 1, 2011, the following two changes will be made to Medical Policy #08.00.78: Self-Injectable Drugs:

• Intron A^®, which includes Intron A Pen^®, will be removed from the policy and will not be available under the pharmacy benefit. It will only be available under the medical benefit, and providers may begin billing for Intron A^® under the medical benefit effective December 8, 2010.
• Tesamorelin (Egrifta) will be added to the Self-Injectable Drugs policy in anticipation of approval from the U.S. Food and Drug Administration (FDA). Tesamorelin (Egrifta) will only be made available under the pharmacy benefit and is not eligible for coverage until the drug receives FDA approval.

Please read the full article in the December issue of Partners in Health Update^SM for more information about these changes, including how your patients can have drugs shipped directly to their home or your office.

To view the medical policy in full, select Medical Policy from the Reference Material and Reports option in the Plan Transactions menu, then select Accept and Go to Medical Policy Online, and then type the policy name or number in the Search box.