This CPB has been revised for continuation of natalizumab (Tysabri) therapy for Crohn’s disease to defined continuation criteria as remission or improvement in abdominal pain or tenderness, diarrhea, body weight, abdominal mass, hematocrit, endoscopic appearance of the mucosa, or improvement on a disease activity scoring tool. This CPB has been updated with the following: (i) for commercial plans, removed brand selection designation for Lemtrada for relapsing forms of multiple sclerosis, (ii) add additional dosage and administration information, (iii) updated the table in the appendix for brands of targeted immune modulators and FDA-approved indications, and (iv) add subheaders and reorganized the CPB.

This CPB has been updated, for Medicare Advantage plans that do not offer prescription drug coverage (MA), to designate Entyvio, Remicade or Renflexis, as preferred brands for Crohn's disease. This CPB has been updated, for Medicare Advantage plans that do not offer prescription drug coverage (MA) and Medicare Advantage plans that offer prescription drug coverage (MAPD), to designate natalizumab (Tysabri) as the preferred brand for relapsing, relapsing-remitting, or active secondary progressive multiple sclerosis.