Effective January 1, 2020, AmeriHealth will be making
changes to the following specialty pharmacy drugs covered under the pharmacy
benefit:
|
Drugs that will be considered specialty pharmacy
|
Drugs that will no longer be considered specialty pharmacy
|
|
Ingrezza®
|
Repatha®
|
|
Rilutek®/Riluzole
|
Praluent®
|
|
Tiglutik™
|
Mercaptopurine
|
|
Cystadane Powder®
|
|
|
D-penamine
|
|
|
Ridaura®
|
|
|
Exjade®/Deferasirox
|
|
|
Alkeran®/Melphalan
|
|
|
Targretin® gel 1%
|
|
Specialty pharmacy drugs
Specialty pharmacy drugs covered under the pharmacy benefit are typically
drugs that are administered by the patient. These may include, but are not
limited to, drugs that are taken orally or administered by injection. Specialty
drugs meet certain criteria, including:
- drugs used to treat rare, complex, or chronic diseases;
- drugs that have complex storage and/or shipping requirements;
- drugs that require comprehensive patient monitoring and education.
Some members may see a change in their cost-share if their prescription drug
formulary includes a specialty tier based on the AmeriHealth member’s
prescription drug benefit design.
Specialty pharmacies
Specialty drugs are typically dispensed by specialty pharmacies. Members
should contact their current pharmacy to determine if the pharmacy will
continue to supply the drug(s) listed above.
Learn more
If you have any questions concerning the specialty drugs covered under the
pharmacy benefit, please contact FutureScripts®
at
1-888-678-7012.