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Updates to the AmeriHealth Pennsylvania medical benefit specialty drug cost-sharing list now in effect

July 2, 2018

As of July 1, 2018, AmeriHealth Pennsylvania updated its list of specialty drugs that require member cost-sharing (i.e., copayment, deductible, and coinsurance). Cost-sharing applies to select medical benefit specialty drugs for members who are enrolled in Commercial FLEX products and other select plans. The member's cost-sharing amount is based on the terms of the member's benefit contract. In accordance with your Provider Agreement, it is the provider's responsibility to verify a member's individual benefits and cost-sharing amounts.

The list has been expanded to include 155 drugs, including additions for the following drugs:

  • Crysvita? (burosumab-twza)
  • IlumyaTM (tildrakizumab-asmn)
  • TrogarzoTM (ibalizumab-uiyk)
  • Eculizumab biosimilar

The comprehensive list of specialty drugs with cost-sharing is available on our website.


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