NYSDOH Communication to All Managed Medicaid Plans: Coverage Discontinued for Zoladex and Other TerSera Therapeutics Drugs
3/29/2022
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Posted by Provider Relations
Effective October 1, 2021, TerSera Therapeutics voluntarily withdrew from participation in the Medicaid Drug Rebate Program (MDRP). As a result, NYS Medicaid fee-for-service (FFS) and Medicaid Managed Care (MMC) will no longer provide coverage for drugs manufactured by TerSera Therapeutics.
Pursuant to Social Security Law Sec. 1927. [42 U.S.C. 1396r–8] (a), Centers for Medicare & Medicaid Services (CMS) requires drug manufacturers to participate in the (MDRP) for their drugs to be eligible for coverage under Medicaid, except in certain circumstances.
The following drugs will no longer be covered by Medicaid effective May 1, 2022: Prialt, Ergomar, Quzyttir, Varubi, Xermelo, Zoladex.
Zoladex (goserelin implant) is a practitioner-administered drug manufactured by TerSera Therapeutics which is available through a Patient Assistance Program from the manufacturer free of charge for those who qualify. For program applications and additional information please visit https://www.zoladexhcp.com/access-support/ or contact TerSera Support Source at 855-686-8725.
Alternatives to Zoladex specific to indication: Lupron (leuprolide acetate), Eligard (leuprolide acetate), Vantas (histrelin acetate implants), Trelstar (triptorelin pamoate)