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Prescription drug updates

December 1, 2011

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For members enrolled in an IBC 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

BrilintaTM

Not available

Heart, Blood Pressure, & Cholesterol

October 4, 2011

Firazyr?

Not available

Heart, Blood Pressure, & Cholesterol

August 26, 2011

GraliseTM

Not available

Pain, Nervous System, & Psych

August 19, 2011

HorizantTM

Not available

Pain, Nervous System, & Psych

July 27, 2011

IncivekTM

Not available

Antibiotics and Other Drugs Used for Infection

August 8, 2011

Lazanda?

Not available

Pain, Nervous System, & Psych

September 30, 2011

Orencia? SQ

Not available

Bones, Joints, & Muscles

October 4, 2011

VictrelisTM

Not available

Antibiotics and Other Drugs Used for Infection

August 8, 2011

Xalkori?

Not available

Cancer & Organ Transplant Drugs

September 2, 2011

Xarelto?

Not available

Heart, Blood Pressure, & Cholesterol

August 29, 2011

Zelboraf?

Not available

Cancer & Organ Transplant Drugs

August 17, 2011

 

The following non-formulary drugs will be added to the list of drugs requiring prior authorization. Members taking these drugs immediately prior to the effective date are not affected:

Effective December 1, 2011.

Brand drug

Generic drug

Drug category

NexiclonTMXR Suspension

Not available

Heart, Blood Pressure, & Cholesterol

TradjentaTM

Not available

Diabetes

Drugs with quantity limits

Quantity limits will be added for the following drugs:

Effective December 1, 2011.

Brand drug

Generic drug

Quantity limit

DificidTM

Not available

20 tablets per 10 days

Sprix?

Not available

5 bottles per 30 days

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