Home Administrative Billing & Reimbursement BlueCard® Health and Wellness Medical PEAR portal Pharmacy Products Quality Management

Prescription drug updates

May 31, 2013

[

For members enrolled in an IBC prescription drug program, prior authorization 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. 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

CometriqTM

Not available

Cancer & Organ Transplant Drugs

January 17, 2013

Eliquis?

Not available

Heart, Blood Pressure, & Cholesterol

January 4, 2013

Gattex?

Not available

Stomach, Ulcer, & Bowel Meds

January 25, 2013

IclusigTM

Not available

Cancer & Organ Transplant Drugs

December 28, 2012

JuxtapidTM

Not available

Heart, Blood Pressure, & Cholesterol

January 17, 2013

Xeljanz?

Not available

Bone, Joint, & Muscle

November 30, 2012



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

Effective July 1, 2013.

Brand drug

Generic drug

Drug category

Actoplus Met? XR

Not available

Diabetes, Thyroid, Steroids, & Other Miscellaneous Hormones

Dolophine?

Not available

Pain, Nervous System, & Psych

Vascepa?

Not available

Heart, Blood Pressure, & Cholesterol

]

This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of Independence Blue Cross. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.
Connect with us     Facebook     Twitter     Flickr     YouTube     Walk the Talk    Independence Pinterest    Independence LinkedIn    Independence Instagram Site Map        Anti-Fraud        Privacy Policy        Legal        Disclaimer
© 2023 Independence Blue Cross.
Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.