Joenja — Blue Cross Blue Shield of Texas

Patients residing in Ohio with fully insured or HIM Shop (SG) coverage

Initial criteria

Member resides in Ohio
Plan is Fully Insured or HIM Shop (SG)
Patient does NOT have any FDA labeled contraindications to the requested agent
ONE of the following: (1) Patient has another FDA labeled indication for the requested agent and route of administration; OR (2) Patient has another indication supported in compendia for the requested agent and route of administration; OR (3) Prescriber submitted TWO peer-reviewed journal articles supporting proposed use as safe and effective (case studies not accepted)
Allowed compendia references: non-oncology (DrugDex level 1, 2A, 2B; AHFS-DI), oncology (NCCN 1 or 2A; AHFS-DI; DrugDex level 1, 2A, 2B; Clinical Pharmacology; LexiDrugs; peer-reviewed medical literature)

12 months