Blue Cross NC updates Tocilizumab utilization criteria to prefer Tyenne, effective January 1, 2025

As of January 1, 2025, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will update its Tocilizumab utilization criteria to prefer Tyenne^®. Actemra^® will be removed from preferred status.

To ensure a smooth transition, patients with a current Actemra prior authorization approval may transition to the preferred product (Tyenne) on January 1, 2025, without requirement of an additional prior authorization at that time. Initial Tyenne prior authorizations will be active through the original Actemra prior authorization approval date. An additional prior authorization will be required after January 1, 2025, to continue Actemra therapy.

Requests for continuation of Actemra will not be able to be reviewed until after January 1, 2025. Please submit all requests through Blue e for fastest processing times.

Learn more about Tocilizumab (Actemra^®) and Tocilizumab Biosimilars.