Prior Authorization for Sarclisa Through OncoHealth

Effective July 1, 2022, coverage of the medication Sarclisa (J9227 – injection, isatuximab-irfc, 10 mg [Sarclisa]) will require prior authorization through OncoHealth for members of Harvard Pilgrim’s Commercial plans.

Sarclisa is used in combination with pomalidomide and dexamethasone to treat adults who have received at least two prior therapies including lenalidomide and a proteasome inhibitor to treat multiple myeloma.

OncoHealth conducts medical review of chemotherapeutic protocols (chemotherapy, support and symptom management drugs) and radiation treatment plans for Harvard Pilgrim members with a cancer diagnosis that requires these services.You can view prior authorization criteria for oncology drugs, as well as any recent coding updates, on the OncoHealth website. To request authorization, contact OncoHealth by fax (800-264-6128), phone (877-222-2021), or online via HPHConnect.

Audrey Kleinberg,
Director, Provider Relations & Communications

Annmarie Dadoly,
Senior Manager, Provider Communications

Joseph O’Riordan,

Kristin Edmonston,
Production Coordinator