Drug Quantity Management Program
October 5, 2023Specialty Clinical Consultation List
October 5, 2023As your Prescription Benefit Facilitator, BeneCard PBF is committed to providing the highest quality service, innovative clinical solutions, and valuable trend management strategies.
BeneCard PBF controls trend through several factors, including our unique pass-through model, generic maximization, clinical programs, and formulary management. The BeneCard PBF Pharmacy and Therapeutics (P&T) Committee continually reviews the latest information available to keep our clinical rules and programs up to date to improve care and reduce costs.
As a result of detailed discussions regarding each medication, its indications, FDA guidelines, and potential member safety issues, the following changes have been approved.
Additions to the Specialty Medication and Standard Clinical Review List
For your reference, we have included the Therapeutic Category as well as the medication use.
- A poly (ADP-ribose) polymerase (PARP) inhibitor.
- Indicated for the treatment of adult patients with deleterious or suspected deleterious BRCA- mutated (BRCAm) metastatic castration-resistant prostate cancer (mCRPC).
- There are warnings for myelodysplastic syndrome/acute myeloid leukemia, myelosuppression, hypokalemia, fluid retention, and cardiovascular adverse reactions, hepatotoxicity, adrenocortical insufficiency, hypoglycemia, increased fractures and mortality in combination with radium 223 dichloride, posterior reversible encephalopathy syndrome, and embryo-fetal toxicity.
- A hematopoietic stem cell mobilizer.
- Indicated in combination with filgrastim (G-CSF) to mobilize hematopoietic stem cells to the peripheral blood for collection and subsequent autologous transplantation in patients with multiple myeloma.
- There are warnings for anaphylactic shock and hypersensitivity reactions, injection site reactions, tumor cell mobilization in patients with leukemia, leukocytosis, potential for tumor cell mobilization, embryo-fetal toxicity.
- A bispecific B-cell maturation antigen (BCMA)-directed CD3 T‑cell engager.
- Indicated for the treatment of adult patients with relapsed or refractory multiple myeloma who have received at least four prior lines of therapy including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 monoclonal antibody.
- There is a black box warning for cytokine release syndrome and neurologic toxicity including immune effector cell-associated neurotoxicity syndrome (ICANS).
- An alkylating drug.
- Indicated as a liver-directed treatment for adult patients with uveal melanoma with unresectable hepatic metastases affecting less than 50% of the liver and no extrahepatic disease, or extrahepatic disease limited to the bone, lymph nodes, subcutaneous tissues, or lung that is amenable to resection or radiation.
- There is a black box warning for severe peri-procedural complications, myelosuppression.