Effective November 1, Inflectra® is the preferred infliximab product for adult Blue Cross' PPO (commercial) members

Please note that this message replaces the previous message we posted on July 30 and then promptly removed. Please refer to the web-DENIS message titled "Clarification: Preferred infliximab strategy for adult Blue Cross' PPO (commercial) members" that we posted on August 8 regarding the updates to this article.

Starting Nov. 1, 2019, Inflectra (infliximab-dyyb; HCPCS Code Q5103) will be the preferred infliximab product for its adult Blue Cross' PPO (commercial) members.

Action required

As of Nov. 1, 2019, adult Blue Cross' PPO (commercial) members with an active authorization for an infliximab product other than Inflectra must transition to Inflectra.

The infliximab products other than Inflectra are:

The authorization requirements apply only to groups that are currently participating in the standard commercial Medical Drug Prior Authorization Program for drugs administered under the medical benefit.

This change doesn't apply to:

Note: This change took effect for BCN HMOSM (commercial) members on May 1, 2019.

Quick links to helpful resources

Note: The Inflectra change will be reflected in the requirements list on November 1.

Posted: July 2019
Line of business: Blue Cross Blue Shield of Michigan