Select Medication List to be Updated Nov. 1, 2021

July 21, 2021

The viscosupplement products on the Select Medication List will be updated effective Nov. 1, 2021.

What's Changing

Euflexxa® Will be removed
Orthovisc® Will be added *
Synvisc-One® Remains on list *

*These are injections from the viscosupplementation class and are used primarily for osteoarthritis knee pain relief.

Please note reimbursement may change to reflect these product changes.

List Location

The current Select Medication List can be found on the provider website under Related Resources on the Specialty Drug Program section of our Pharmacy Program page. This list will be updated with the above changes prior to the Nov. 1, 2021 implementation.

 

The listing of any particular drug or classification of drugs is not a guarantee of benefits. Payment of benefits is subject to several factors, including, but not limited to, eligibility at the time of service, terms, conditions, limitations and exclusions set forth in the member's policy or benefits document. Members should refer to their contract of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any medication is between the member and their health care provider.

Euflexxa is a registered trademark of Ferring B.V. Orthovisc is a registered trademark of DePuy Synthes. Synvisc-One is a registered trademark of Genzyme Corporation.