Medications Approved for Automatic Therapeutic Interchange Dosage Conversion Guidelines (Note: “Therapeutic Interchange” should be placed in the order comments)
**Exception: Avastin is the only bevacizumab product with off-label approval for intravitreal administration in ophthalmic indications.**
Biosimilar and Reference Products Interchange List for Adults
Medication
Reference Drug or Biosimilar
Formulary Status
Automatic Therapeutic Interchange
Inpatient1
Outpatient
*New Starts/New Authorizations Only*
Zirabev (bevacizumab-bvzr)
Biosimilar
Formulary
Use Zirabev
Interchange to Mvasi unless third party payer requires other bevacizumab product
Mvasi (bevacizumab-awwb)
Biosimilar
Formulary, restricted to OP
(preferred)
Interchange to Zirabev
Use Mvasi unless third party payer requires other bevacizumab product
Alymsys (bevacizumab-maly)
Vegzelma (bevacizumab-adcd)
Biosimilars
Formulary, restricted to OP
(not preferred)
Interchange to Zirabev
Interchange to Mvasi unless third party payer requires other bevacizumab product
Avastin (bevacizumab)
Reference
Formulary, restricted to OP or intravitreal administration
(not preferred)
Interchange to Zirabev unless for intravitreal route
Interchange to Mvasi unless third party payer requires other bevacizumab product or for intravitreal route
Hepatocellular cancer approval: only Avastin is FDA approved. However, NCCN Guidelines for Hepatocellular Carcinoma state: “an FDA-approved biosimilar is an appropriate substitute for bevacizumab.” Avastin is the only bevacizumab product with off-label approval for intravitreal administration in ophthalmic indications.
Chemotherapy Chart
Medications Approved for Automatic Therapeutic Interchange Dosage Conversion Guidelines
(Note: “Therapeutic Interchange” should be placed in the order comments)
**Exception: Avastin is the only bevacizumab product with off-label approval for intravitreal administration in ophthalmic indications.**
Biosimilar and Reference Products Interchange List for Adults
Medication
Reference Drug or Biosimilar
Formulary Status
Automatic Therapeutic Interchange
Inpatient1
Outpatient
*New Starts/New Authorizations Only*
Zirabev (bevacizumab-bvzr)
Biosimilar
Formulary
Use Zirabev
Interchange to Mvasi unless third party payer requires other bevacizumab product
Mvasi (bevacizumab-awwb)
Biosimilar
Formulary, restricted to OP
(preferred)
Interchange to Zirabev
Use Mvasi unless third party payer requires other bevacizumab product
Alymsys (bevacizumab-maly)
Vegzelma (bevacizumab-adcd)
Biosimilars
Formulary, restricted to OP
(not preferred)
Interchange to Zirabev
Interchange to Mvasi unless third party payer requires other bevacizumab product
Avastin (bevacizumab)
Reference
Formulary, restricted to OP or intravitreal administration
(not preferred)
Interchange to Zirabev unless for intravitreal route
Interchange to Mvasi unless third party payer requires other bevacizumab product or for intravitreal route
Hepatocellular cancer approval: only Avastin is FDA approved. However, NCCN Guidelines for Hepatocellular Carcinoma state: “an FDA-approved biosimilar is an appropriate substitute for bevacizumab.” Avastin is the only bevacizumab product with off-label approval for intravitreal administration in ophthalmic indications.