Waste avoidance program expansion starting March 1, 2021, for commercial members

To minimize drug waste, reduce unnecessary drug exposure and decrease the risk of adverse events, we're expanding our waste avoidance program to include additional drugs, effective March 1, 2021.

This change affects Blue Cross Blue Shield of Michigan commercial and Blue Care Network commercial members who receive these drugs:

• Onpattro^®, HCPCS code J0222
• Orencia^®,* HCPCS code J0129
• Stelara^®, HCPCS code J3357
• Stelara IV^®,* HCPCS code J3358
• Soliris^®, HCPCS code J1300
• Ultomiris^®, HCPCS code J1303

*In addition to Blue Cross commercial and BCN commercial members, the dosing strategy change for this drug applies to UAW Retiree Medical Benefits Trust non-Medicare members.

When this change takes effect, dosing for these therapies will be based on weight and will be specific to:

• The dosing guidelines of the U. S. Food and Drug Administration and the manufacturer
• Current medical best practices

This change will apply to members who start therapy and members whose authorizations are renewed on or after March 1. Members whose current authorizations for these drugs extend past March 1, 2021, can continue at their current dose until their authorization expires.

Members NOT affected by this change

This change doesn’t apply to:

• Blue Cross and Blue Shield Federal Employee Program^® members
• BCN Advantage^SM members
• Medicare Plus Blue^SM members

Lists of requirements

To view the requirements for these drugs, see the following drug lists:

• Standard commercial medical drug program: Blue Cross and BCN utilization management medical drug list for Blue Cross PPO (commercial) and BCN HMO (commercial) members (PDF) document
• UAW Retiree Medical Benefits Trust non-Medicare members: Medical Drug Management with Blue Cross for UAW Retiree Medical Benefit Trust PPO non-Medicare members (PDF)
• FEP non-Medicare members: Utilization management medical drug list for Blue Cross and Blue Shield Federal Employee Program^® non-Medicare members (PDF)

We'll update these drug lists with this information about the change in dosing strategy prior to March 1.