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Prescription drug updates

March 1, 2013

For members enrolled in an AmeriHealth prescription drug program, prior authorization and quantity limit requirements will be applied to certain drugs. The purpose of prior authorization is to ensure that drugs are medically necessary and are being used appropriately. Quantity limits are designed to allow a sufficient supply of medication based upon the maximum daily dose and length of therapy approved by the U.S. Food and Drug Administration for a particular drug. The most recent updates are reflected below.

Drugs requiring prior authorization


The prior authorization requirement for the following non-formulary drugs was effective at the time the drugs became available in the marketplace:
Brand drug Generic drug Drug category Effective date Aubagio? Not available Pain, Nervous System, & Psych September 28, 2012 QsymiaTM Not available Diagnostics & Miscellaneous September 7, 2012 Stivarga? Not available Cancer & Organ Transplant Drugs September 28, 2012
The following prior authorization requirements for the following non-formulary drugs are effective at the time indicated below:
Brand drug Generic drug Drug category Effective date Solodyn? Not available Antibiotics & Other Drugs Used for Infection April 1, 2013 Xyrem? Not available Pain, Nervous System, & Psych April 1, 2013

Drug with quantity limits


Quantity limits will be added for the following drug:
Effective April 1, 2013.
Brand drug Generic drug Drug category Quantity limit (per 30 days) Xyrem? Not available Pain, Nervous System, & Psych 540ml

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