New Medical Drugs: Empaveli and Ryplazim

Beginning Oct. 8, 2021, Harvard Pilgrim will cover the following new medications with prior authorization for commercial members:

  • Empaveli (HCPCS J3490: unclassified drug)
  • Ryplazim (HCPCS J3590: unclassified drug)

To request authorization, please contact CVS Health–NovoLogix via phone (844-387-1435) or fax (844-851-0882).

For complete information, including coverage criteria and FDA-approved maximum dosage and frequency limits, please refer to the applicable policies.

Publication Information

Annmarie Dadoly,

Joseph O’Riordan,

Kristin Edmonston,
Production Coordinator