Welcome to the New Century Health - Medical Oncology Policies page. Members follow the Medical Policies for the company underwriting or administering their benefit plan. See Frequently Asked Questions: ConnectiCare Oncology Drug Management to learn about the Medical Oncology Program and who these policies apply to.
See also:
Policies are listed in alphabetical order.
| A back to top |
Download (PDF) |
|---|---|
| Abraxane (nab paclitaxel) | Download (PDF) |
| Adakveo (crizanlizumab) | Download (PDF) |
| Adcetris (brentuximab vedotin) | Download (PDF) |
| Adstiladrin | Download (PDF) |
| Adzynma | Download (PDF) |
| Alimta and Pemfexy | Download (PDF) |
| Aliqopa (copanlisib) | Download (PDF) |
| Amtagvi | Download (PDF) |
| Anktiva | Download (PDF) |
| Antiemetics | Download (PDF) |
| Arranon (nelarabine) | Download (PDF) |
| Arzerra | Download (PDF) |
| Aphexda | Download (PDF) |
| Asparlas (calaspargase pegol-mknl) | Download (PDF) |
| Avastin (bevacizumab) and Biosimilars (Mvasi and Zirabev) | Download (PDF) |
| B back to top |
Download (PDF) |
|---|---|
| Bavencio | Download (PDF) |
| Beleodaq (belinosat) | Download (PDF) |
| Besponsa | Download (PDF) |
| Besremi (ropeginterferon alfa-2b-nijft) | Download (PDF) |
| Blenrep (belantamab mafodotin-blmf) | Download (PDF) |
| Blincyto (blinatumomab) | Download (PDF) |
| Bone Modifying Agents (Aredia Zometa Xgeva Prolia) | Download (PDF) |
| C back to top |
Download (PDF) |
|---|---|
| Cablivi (caplacizumab-yhdp) | Download (PDF) |
| Clolar (clofarabine) | Download (PDF) |
| Columvi | Download (PDF) |
| Cosela (trilaciclib) | Download (PDF) |
| Cyramza (ramucirumab) | Download (PDF) |
| D back to top |
Download (PDF) |
|---|---|
| Danyelza (naxitamab-gqgk) | Download (PDF) |
| Darzalex and Darzalex Faspro (daratumumab) | Download (PDF) |
| Doxil or Lipodox | Download (PDF) |
| E back to top |
Download (PDF) |
|---|---|
| Elahere | Download (PDF) |
| Elrexfio™ (elranatamab-bcmm) | Download (PDF) |
| Elzonris (tagraxofusp) | Download (PDF) |
| Empaveli (pegcetacoplan) NCH | Download (PDF) |
| Empliciti | Download (PDF) |
| Enhertu (fam-trastuzumab deruxtecan-nxki) | Download (PDF) |
| Enjaymo (sutimlimab-jome) | Download (PDF) |
| Erbitux (cetuximab) | Download (PDF) |
| Erwinaze and Rylaze (asparaginase Erwinia chrysanthemi and recombinantrywn) | Download (PDF) |
| Erythropoiesis Stimulating Agents (Aranesp, Epogen, Procrit, Retacrit) | Download (PDF) |
| F back to top |
Download (PDF) |
|---|---|
| Faslodex | Download (PDF) |
| Folotyn | Download (PDF) |
| Fusilev | Download (PDF) |
| Fyarro (sirolimus) |
Download (PDF) |
| G back to top |
Download (PDF) |
|---|---|
| Gamifant (emapalumab-lzsg) | Download (PDF) |
| Gazyva | Download (PDF) |
| Generic Oncology | Download (PDF) |
| H back to top |
Download (PDF) |
|---|---|
| Halaven | Download (PDF) |
| I back to top |
Download (PDF) |
|---|---|
| Imdelltra | Download (PDF) |
| Imfinzi | Download (PDF) |
| Imjudo | Download (PDF) |
| Imlygic | Download (PDF) |
| Intravenous Immune Globulin (Aceniv, Panzyga, Bivigam, Carimune, Cuvitru, Gammagard, Gammaplex, Gamunex, Hiqvia, Gammaked, Octagam, Privigen) | Download (PDF) |
| Iressa (gefitinib) | Download (PDF) |
| Istodax | Download (PDF) |
| Ixempra | Download (PDF) |
| J back to top |
Download (PDF) |
|---|---|
| Jelmyto (mitomycin for pyelocalyceal instillation) | Download (PDF) |
| Jemperli (dostarlimab-gxly) | Download (PDF) |
| Jevtana | Download (PDF) |
| K back to top |
Download (PDF) |
|---|---|
| Kadcyla | Download (PDF) |
| Keytruda (pembrolizumab) | Download (PDF) |
| Kimmtrak (tebentafusp-tebn) | Download (PDF) |
| Kyprolis (carfilzomib) | Download (PDF) |
| L back to top |
Download (PDF) |
|---|---|
| LHRH (Agonists and antagonist) | Download (PDF) |
| Libtayo (cemiplimab-rwlc) | Download (PDF) |
| Loqtorzi | Download (PDF) |
| Lumoxiti | Download (PDF) |
| Lunsumio | Download (PDF) |
| Lymphir | Download (PDF) |
| M back to top |
Download (PDF) |
|---|---|
| Margenza (margetuximab-cmkb) | Download (PDF) |
| Marqibo (vincristine liposome) | Download (PDF) |
| Monjuvi (tafasitamab-cxix) | Download (PDF) |
| Mozobil (plerixafor) | Download (PDF) |
| Myeloid Growth Factors (Fulphila, Granix, Leukine, Neulasta, Neupogen, Nivestym, Nyvepria, Udenyca and Zarxio) | Download (PDF) |
| Mylotarg | Download (PDF) |
| N back to top |
Download (PDF) |
|---|---|
| Nplate | Download (PDF) |
| O back to top |
Download (PDF) |
|---|---|
| Oncaspar (pegaspargase) | Download (PDF) |
| Onivyde (irinotecan liposome) | Download (PDF) |
| Opdivo (nivolumab) | Download (PDF) |
| Opdualag (nivolumab and relatlimab-rmbw) | Download (PDF) |
| P back to top |
Download (PDF) |
|---|---|
| Padcev (enfortumab vedotin-ejfv) | Download (PDF) |
| Pedmark (sodium thiosulfate) | Download (PDF) |
| Pepaxto (melphalan flufenamide) | Download (PDF) |
| Photofrin (porfimer) | Download (PDF) |
| Piasky | Download (PDF) |
| Polivy (polatuzumab vedotin) | Download (PDF) |
| Poteligeo | Download (PDF) |
| Provenge | Download (PDF) |
| Q back to top |
Download (PDF) |
|---|
| R back to top |
Download (PDF) |
|---|---|
| Reblozyl (luspatercept-aamt) | Download (PDF) |
| Rituximab Products (Riabni, Rituxan Hyclea, Ruxience, Truxima) | Download (PDF) |
| Rybrevant (amivantamab-vmjw) | Download (PDF) |
| Rytelo | Download (PDF) |
| S back to top |
Download (PDF) |
|---|---|
| Sarclisa (isatuximab-irfc) | Download (PDF) |
| Soliris (eculizumab) | Download (PDF) |
| Somatostatin Analog (Sandostatin and Somatuline) | Download (PDF) |
| Sylvant (siltuximab) | Download (PDF) |
| Synribo (omacetaxine) | Download (PDF) |
| T back to top |
Download (PDF) |
|---|---|
| Talvey (talquetamab-tgvs) | Download (PDF) |
| Tecentriq | Download (PDF) |
| Tecelra | Download (PDF) |
| Tecvayli | Download (PDF) |
| Tepadina (thiotepa) | Download (PDF) |
| Tivdak (tisotumab vedotin-tftv) | Download (PDF) |
| Torisel (temsirolimus) | Download (PDF) |
| Trastuzumab Products and Phesgo (pertuzumab trastuzumab and hyaluronidase-zzxf) Herceptin, Herzuma, Kanjinti, Ogivri, Ontruzant, Trazimera | Download (PDF) |
| Treanda_Bendeka_Belrapzo | Download (PDF) |
| Trisenox (arsenic trioxide) | Download (PDF) |
| Trodelvy (sacituzumab govitecan-hziy) | Download (PDF) |
| U back to top |
Download (PDF) |
|---|---|
| Ultomiris (ravulizumab) | Download (PDF) |
| Unituxin (dinutuximab) | Download (PDF) |
| V back to top |
Download (PDF) |
|---|---|
| Valstar (valrubicin) | Download (PDF) |
| Vectibix (panitumumab) | Download (PDF) |
| Velcade (bortezomib) | Download (PDF) |
| Vyxeos | Download (PDF) |
| W back to top |
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|---|
| X back to top |
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|---|
| Y back to top |
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|---|---|
| Yervoy (ipilimumab) | Download (PDF) |
| Yondelis (trabectedin) | Download (PDF) |
| Z back to top |
Download (PDF) |
|---|---|
| Zaltrap (ziv-aflibercept) | Download (PDF) |
| Zepzelca (lurbinectedin) | Download (PDF) |
| Zynlonta (loncastuzimab tesirine-lpyl) | Download (PDF) |
| Zynyz (retifanlimab-dlwr) | Download (PDF) |
