This CPB has been revised to state that that the following are considered experimental and investigational: (i) intravitreal bevacizumab (Avastin), bevacizumab-awwb (Mvasi), and bevacizumab-bvzr (Zirabev) injections for the treatment of amelanotic melanoma / "leakage" from an amelanotic choroid malignancy; (ii) subconjunctival injection of bevacizumab, bevacizumab-awwb, and bevacizumab-bvzr for the management of bleb encapsulation/needling following trabeculectomy; and (iii) intravitreal aflibercept (Eylea) injections for the treatment of choroidal neovascularization due to ocular histoplasmosis.

This CPB has been updated with the following: (i) for Aetna commercial plans, change "Least Cost Medically Necessary Brands" subheading to "Brand Selection for Medically Necessary Indications", (ii) update nomenclature for "Brand Selection for Medically Necessary Indications" to reflect Aetna commercial plan language, (iii) add note to the Dosage and Administration section that Macugen was withdrawn from the U.S. market, and (iv) added and reorganized subheaders.