Neighborhood is making important changes to our Medical Benefit Formularies across all lines of business (Medicaid, Commercial/Exchange and INTEGRITY MMP), as well as our Medicaid Pharmacy Benefit Formulary. These changes will help keep health care costs as low as possible for Neighborhood members, while ensuring safe and effective prescription drug utilization.
Starting on October 1, 2021, the following changes will occur on Neighborhood’s Medical Benefit and Medicaid Pharmacy Benefit Formulary:
- The preferred Granulocyte Colony-Stimulating Factor (G-CSF) product will now be Zarxio.
- An exception will be made for patients who are unable to self-administer Zarxio AND are unable to travel to the clinic for Zarxio injections. These patients will be approved for a Long-Acting G-CSF as will patients with a documented intolerance, contradiction, or failure on short-acting G-CSF, Zarxio.
- When indicated, Neighborhood’s preferred Long-Acting G-CSF will be Ziextenzo and Neulasta.
All members on a Long-Acting G-CSF prior to October 1, 2021, will continue to have access to the Long-Acting G-CSF product they were utilizing for the duration of their current chemotherapy regimen.