New Preferred Drugs

New Preferred Drugs

Beginning July 1, 2021, the following drugs will be considered non-preferred by BlueCross BlueShield of South Carolina and BlueChoice HealthPlan.  This means that the current, non-preferred drug will still be covered, but the member’s cost share will be increased.

Drug Class Current, Non-preferred Drug New, Preferred Drug
Autoimmune Remicade (infliximab) Inflectra, Renflexis

Granulocyte Colony Stimulating

Factors, Long Acting

Neulasta (pegfilgrastim) Neulasta, Ziextenzo

Granulocyte Colony Stimulating

Factors, Short Acting

Neupogen (filgrastim) Zarxio, Nivestym
Oncology/B-cell Malignancies Rituxan (rituximab) Truxima, Ruxience

Oncology/First of Second Line

Multiple Cancer Indications

Avastin (bevaxizumab) Mvasi, Zirabev
Oncology/HER2 Positive Breast Cancer Herceptin (trustuzumab) Kanjinti, Trazimera

Both preferred and non-preferred drugs require prior authorization (PA) before they are covered, which can be obtained by calling 877-440-0089.  If members currently have an active PA for a non-preferred drug, before it expires, a new request should be made for a preferred drug.

If you have a patient that you want to continue taking their current, non-preferred drug, you will need to provide appropriate documentation before the current PA expires.

  • If the PA is approved, the member will be able to continue to have their prescription filled as usual.  However, their cost share may increase, and the amount paid will not count towards their deductible and out-of-pocket maximums.
  • If the PA is not approved and the member has a prescription for a non-preferred drug filled after the current PA expires, they will have to pay the full cost of the drug.

Note: These changes apply to all commercial lines of business.

If you have any questions, please contact Provider Education using the Provider Education Contact Form located on www.BlueChoiceSC.com.