New Jersey Medicaid: Addressing drugs shortages for oncology use
UnitedHealthcare is closely monitoring oncology drug shortages listed on the U.S. Food and Drug Administration and American Society of Health-system Pharmacists sites. To help address current oncology drug shortages and minimize care delay, we’ve updated our prior authorization process.
What is changing?
- We are expediting reviews for alternative medicine and/or regimen prior authorization requests
- If a drug is on the shortage list and an alternative drug or regimen is supported by the National Comprehensive Cancer Network (NCCN®) guidelines,1 your request will be approved
- If a drug is on the shortage list and an alternative drug or regimen is not supported by the NCCN guidelines, then the prior authorization request will be pended for an oncologist review. If appropriate, these requests will be approved for 6 months during the drug shortage.
- You do not need to request a new prior authorization for the same medication if you are changing the time between doses, as recommended by the American Society of Clinical Oncology (ASCO). However, when the prior authorization period ends, you need to request a new one to continue therapy.
| Medication shortage | Alternative medication(s) |
|---|---|
| Carboplatin | Oxaliplatin, cisplatin |
| Cisplatin | Oxaliplatin, carboplatin |
| Docetaxel | Paclitaxel, cabazitaxel, Abraxane® |
| Capecitabine | Xeloda®, fluorouracil |
Updated on June 02, 2023
We will continue to monitor these drug shortages and provide additional updates as needed.
Questions?
Please call the Optum Cancer Authorization Program at 888-397-8129 7 a.m.–7 p.m. CT, Monday–Friday, email unitedoncology@uhc.com or find more information about cancer prior authorization on our website.
1References:
The NCCN Clinical Practice Guidelines in Oncology.
American Society of Clinical Oncology. Drug Shortages. Retrieved June 2, 2023.
American Society of Health-System Pharmacists: Managing Drug Product Shortages. Retrieved June 2, 2023.
