For commercial 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 Farxiga? Not available Diabetes, Thyroid, Steroids, & Other Miscellaneous Hormones January 27, 2014 Imbruvica? Not available Cancer & Organ Transplant Drugs November 18, 2013 Olysio? Not available Antibiotics & Other Drugs Used for Infection December 2, 2013 Otrexup? Not available Bone, Joint, & Muscle December 30, 2013 Sovaldi? Not available Antibiotics & Other Drugs Used for Infection December 16, 2013 Stendra? Not available Urinary & Prostate Meds January 13, 2014

The following drugs have been added to the list of drugs requiring prior authorization:

Brand drug Generic drug Drug category Effective date Adasuave^® Not available Pain, Nervous System, & Psych July 1, 2014 Advair^® Not available Allergy, Cough & Cold, Lung Meds July 1, 2014 Aerospan? Not available Allergy, Cough & Cold, Lung Meds July 1, 2014 Alvesco^® Not available Allergy, Cough & Cold, Lung Meds July 1, 2014 Exalgo? Not available Pain, Nervous System, & Psych July 1, 2014 Fetzima? Not available Pain, Nervous System, & Psych July 1, 2014 Flovent^® Not available Allergy, Cough & Cold, Lung Meds July 1, 2014 Pulmicort Flexhaler^® Not available Allergy, Cough & Cold, Lung Meds July 1, 2014

Drugs with quantity limits

Quantity limits will be added for the following drugs:

Brand drug Generic drug Quantity limit Effective date Aciphex^® rabeprazole* 30 tabs per 30 days November 18, 2013 Focalin? XR dexmethylphenidate hcl* 30 tabs per 30 days November 25, 2013 Stendra? Not available 8 tabs per 30 days January 13, 2014 Zomig^® Spray 2.5 mg Not available 9 bottles per 30 days July 1, 2014

*Quantity limits currently exist for brand drugs and will apply to generics at the dates indicated above.

Drug no longer requiring prior authorization

Prior authorization was removed for the following drug:

Brand drug Generic drug Formulary chapter Effective date Tecfidera^® Not available Pain, Nervous System, & Psych May 1, 2014

For additional information on pharmacy policies and programs, please visit our Pharmacy Information web page.