White Blood Cell Colony Stimulating Factors Oh Cs
UnitedHealthcare Medical Benefit Drug Policy for white blood cell colony stimulating factor (CSF) products applicable only to Ohio members; covers list of long-acting and short-acting CSF agents for non-oncology conditions and references Ohio Department of Medicaid criteria and separate oncology policy for oncology indications.
Revised list of applicable white blood cell colony stimulating factors (CSFs) for non-oncology conditions; added Ryzneuta (efbemalenograstim alfa-vuxw).
Coverage Summary
This policy applies only to Ohio and covers white blood cell colony stimulating factor (CSF) products for non-oncology conditions, including the listed long-acting and short-acting CSF agents; it references the Ohio Department of Medicaid Unified Preferred Drug List Criteria for medical necessity and directs oncology indications to a separate Oncology Medication Clinical Coverage policy (do not duplicate oncology criteria).
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