Interferons

Aetna deems interferons medically necessary only for the specific, listed indications: interferon alfa‑2b (Intron A) for certain malignancies and chronic hepatitis B/C and ocular surface neoplasia; interferon alfa‑n3 (Alferon N) for intralesional refractory/recurring external condylomata acuminata; interferon beta‑1a (Avonex) for relapsing MS and clinically isolated syndrome; interferon gamma‑1b (Actimmune) for chronic granulomatous disease, severe malignant osteopetrosis, and mycosis fungoides/Sezary syndrome; and peginterferon alfa‑2a (Pegasys) for specified hematologic, hepatic and other disorders. Key requirements: Avonex must be prescribed by/with a neurologist and precertified (and not used with other disease‑modifying MS agents), some agents require specialty prescribers, and continuation/duration limits and reauthorization are allowed only with documented clinical benefit and absence of unacceptable toxicity (e.g., Intron A HCV up to 96 weeks, HBV up to 24 weeks, hairy cell leukemia up to 6 months).