Pharmacy Policies Available September Online

Blue Cross Blue Shield of North Dakota (BCBSND) regularly develops and revises pharmacy policies in response to rapidly changing pharmaceutical requirements. Our commitment is to update the provider community as pharmacy policies are adopted and/or revised. These policy’s will be updated within the next 30-45 days.

The following medical drug policy is new and requires precertification:

  • Chimeric Antigen Receptor Therapy for Multiple Myeloma

The following medical drug policy is new:

  • Aducanumab-avwa (Aduhelm)

The following medical drug policies were revised:

  • Carfilzomib (Kyprolis)
  • Continuous Glucose Monitoring Systems
  • Eculizumab (Soliris) and Ravulizumab (Ultomiris)
  • Onasemnogene abeparvovec-xioi (Zolgensma)
  • Panitumumab (Vectibix)
  • Pertuzumab (Perjeta)
  • Pralatrexate (Folotyn)
  • Ramucirumab (Cyramza)
  • Sacituzumab govitecan-hziy (Trodelvy)

The following medical drug policy was retired 7/5/21:

  • Bamlanivimab 

The following medical drug policy will be retired 8/31/21:

  • Idecabtagene vicleucel (Abecma)

The following medical drug policies were reviewed with no clinical content change:

  • Belatacept (Nulojix)
  • Brentuximab Vedotin (Adcetris)
  • Elosulfase alfa (Vimizim)
  • Fulvestrant (Faslodex)
  • Galsulfase (Naglazyme)
  • Givosiran (Givlaari)
  • Implantable Hormone Replacement Pellets
  • Injectable Collagenase Clostridium Histolyticum (Xiaflex)
  • Moxetumomab Pasudotox-tdfk (Lumoxiti)
  • Obinutuzumab (Gazyva)
  • Portable External Infusion Pump
  • Ziv-aflibercept (Zaltrap)