For commercial members enrolled in an Independence prescription drug program, prior authorization and quantity limitrequirements will be applied to certain drugs. The purpose of prior authorization is to ensure that drugs are medicallynecessary and are being used appropriately. Quantity limits are designed to allow a sufficient supply of medicationbased upon the maximum daily dose and length of therapy approved by the U.S. Food and Drug Administration for aparticular 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 becameavailable in the marketplace:

*Generic requires prior authorization.
^†Covered under pharmacy and medical benefit.

Effective January 1, 2017, the following non-formulary drugs will be added to the list of drugs requiring priorauthorization:

*Generic requires prior authorization.

Drugs with quantity limits

Quantity limits were/will be added or updated for the following drugs as of the date indicated below:

Drugs no longer requiring prior authorization

Effective January 1, 2017, the prior authorization requirement was removed for the following drugs:

For additional information on pharmacy policies and programs, please visit our website.