Regence Policy Reversed: The decision from Regence to mandate the switch from Rituxan patients to Ruxience has been reversed and Regence will approve Rituxan patients currently on treatment to continue for 1 year. If you have already submitted the authorization for the patients, then just re-submit their name, DOB and member # via fax to your pharmacy dept. If you haven’t yet submitted an auth, then please submit auth as you normally would.

The pieces that were challenged by Arthritis Northwest Regence’s policy with were:

  1. The article (download and keep for your files) clearly stating that biosimilars can be substituted only if approved by FDA as “interchangeable.” In addition, substitution can only be allowed if the prescriber has not designated on the prescription that substitution is prohibited.
  2. The concern that my physicians felt regarding “Switching” a stable patient to a non FDA indicated treatment when there are other alternative biosimilars on the market that are indicated for RA.
  3. The Washington State Step Therapy Legislation #1879 which clearly outlines the exemption process for immediately granting the request if patient is stable and doing well on treatment.

This is a major “win” in keeping our physicians at the forefront of healthcare. Allowing physicians who are in the position for making the right decision of treatment for the best clinical outcome and accountability for total cost of care, always delivers the best possible patient centered care.

Regence Rituxan to Ruxience has been Reversed