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Independence drug program formulary updates

May 5, 2021

Effective July 1, 2021, Independence will make changes to its Select Drug Program® Formulary and Value Formulary, including:

  • Generic additions
  • Prior authorization
  • Morphine milligram equivalent, age, and quantity limits
  • Non-preferred brand

Albuterol HFA aerosol

Effective July 1, 2021, Albuterol HFA aerosol (authorized generic of Ventolin® HFA brand only) will require a prior authorization, including documentation of inadequate response or inability to tolerate the brand version, Proair® HFA aerosol. It will also have a quantity limit of two inhalers per 30 days. Albuterol HFA aerosol will be considered non-preferred on the Select Drug Program and Value formulary.

Albuterol HFA inhalers are indicated for the treatment or prevention of bronchospasm in patients with reversible obstructive airway disease, including asthma and chronic obstructive pulmonary disease (COPD).

Note: Generic albuterol (brand ProAir® and Proventil®) is covered under the generic cost-share tier on the Select Drug Program formulary and Value formulary.

Learn more

Review the changes that go into effect July 1, 2021:

To view Select Drug Formulary information for your patients who carry an Independence Administrators ID card, visit the Independence Administrators website.

For more on Independence pharmacy policies and programs, visit our website.



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