Oncology drug dose rounding pilot begins January 1, 2025

December 2, 2024

On January 1, 2025, Cigna HealthcareSM will begin an oncology drug dose rounding pilot program to reduce drug waste for a variety of injectable oncology drugs while maintaining a therapeutic response. This pilot will begin with the oncology drugs listed in the table below.

To optimize drug dosage, drugs included in the pilot will be rounded down to the nearest vial size when the difference between the prescribed drug and vial size is within 5 to 10 percent. This follows the recommendation of the Hematology/Oncology Pharmacy Association and is endorsed by the American Society of Clinical Oncology, and the National Comprehensive Cancer Network.

Considerations

  • EviCore by Evernorth® manages all prior authorizations for oncology drugs. After the pilot program begins, you will notice changes to the EviCore prior authorization website when prescribing one of the impacted drugs. For more information about this change, please refer to the quick reference guide.
  • Drugs in multi-dose Vials, oral chemotherapeutics, erythropoiesis-stimulating agents, radioactive drugs, and drugs with flat doses are excluded from this program.
National Drug CodeDrug
J9034Bendeka® (bendamustine hydrochloride)
J9035Avastin® (bevacizumab)
J9041Velcade® (bortezomib)
J9042Adcetris® (brentuximab vedotin)
J9043Jevtana® (cabazitaxel)
J9047Kyprolis® (carfilzomib)
J9055Erbitux® (cetuximab)
J9145Darzalex® (daratumumab)
J9179Halaven® (eribulin mesylate)
J9228Yervoy® (ipilumumab)
J9264Abraxane® (paclitaxel) (albumin-bound)
J9299Opdivo® (nivolumab)
J9303Vectibix® (panitumumab)
J9305Alimta® (pemetrexed)
J9308Cyramza® (ramucirumab)
J9309Polivy® (polatuzumab vedotin-piiq)
J9312Rituxan® (rituximab)
J9354Kadcyla® (ado-trastuzumab emtansine)
J9355Herceptin® (trastuzumab)
J9358Enhertu® (fam-trastuzumab deruxtecan-nxki)
Q2050Doxil® (doxorubicin hydrochloride liposome injection)
Q5107Mvasi® (bevacizumab-awwb)
Q5112Ontruzant® (trastuzumab-dttb)
Q5113Herzuma® (trastuzumab-pkrb)
Q5114Ogivri® (trastuzumab-dkst)
Q5115Truxima® (rituximab-abbs)
Q5116Trazimera® (trastuzumab-qyyp)
Q5117Kanjinti® (trastuzumab-anns)
Q5118Zirabev® (bevacizumab-bvzr)
Q5119Ruxience® (rituximab-pvvr)
Q5123Riabni® (rituximab-arrx)

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