Blue Cross NC Updates Utilization Criteria for Intravenous Iron Replacement Therapy

Effective April 1, 2023, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will update its Intravenous Iron Replacement Therapy utilization criteria to require use of two preferred products [e.g., sodium ferric gluconate complex in sucrose (Ferrlecit^®), iron sucrose (Venofer^®), iron dextran (INFeD^®), ferumoxytol (Feraheme^®)] for adults, in place of previous requirements for use of one preferred product. Other existing requirements for use of preferred products within the criteria will be restructured according to clinically appropriate age. Of note, effective April 1, 2023, there will no longer be any restrictions in place for Feraheme (ferumoxytol).

Any existing authorizations for restricted products (i.e., Injectafer^® or Monoferric^®) will be active through the original prior authorization approval date. For further information, please read our Corporate Medical Policy (PDF).

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