June 7, 2018
The U.S. Food and Drug Administration (FDA) approved two CAR T-cell therapies (Kymriah™ and Yescarta®) and one genetic therapy (Luxturna™) in 2017.
Kymriah is used in treating acute lymphoblastic leukemia (ALL) in children and relapsed/refractory large B-cell lymphoma (DLBCL) in adults. Yescarta is a treatment for non-Hodgkin lymphoma, and Luxturna is a one-time gene therapy for individuals with an inherited retinal disease.
Premera has medical policies for all three therapies. The medical policies outline when the therapies meet medical necessity for your patients.
Medical policies
Premera medical policy on Chimeric Antigen Receptor (CAR) T Cell Therapies
Gene Therapy for Inherited Retinal Dystrophy with Luxturna™ (Voretigene Neparvovec)
Premera is partnering with manufacturers, distributers, and provider systems to ensure that our customers have access to high quality facilities and receive the right pricing for these expensive therapies.
Since these therapies are available at limited locations, we’ll work with our customers to support them in navigating their treatment path through our personal health support program.
As new therapies are approved by the FDA, Premera will implement evidence-based medical policies to ensure safety and offer the best care for our customers.