The drug Ipilimumab (Yervoy™) is considered medically necessary for adjuvant melanoma. However, adjuvant Yervoy therapy is a non-covered service for BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan members. Bristol Myers Squibb, the drug’s manufacturer, currently provides this therapy free of charge to patients if they enroll in the Adjuvant Patient Program and meet the qualifications as outlined by the manufacturer. Patients may enroll in the program by calling Bristol Myers Squibb at 1-800-861-0048, or by visiting their website at www.bmsaccesssupport.com or http://www.bmsaccesssupport.bmscustomerconnect.com/. As additional information, this treatment is administered intravenously, 10/mg/kg over 90 minutes every three weeks for four doses, followed by 10 mg/kg every 12 weeks for up to three years or until documented disease recurrence or unacceptable toxicity.
For the complete medical policy about Ipilimumab (Yervoy), CAM 091, go to the medical policies section of our websites. Also, if you have questions about this bulletin, you may contact Provider Education at 803-264-4730 or submit your question using the Provider Education Contact Form.
BlueChoice® HealthPlan of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association.