BCBSTX Medicare Part D formulary changes for 2010
The Medicare Part D annual six-week open enrollment period ended Dec. 31, 2009. In mid-October, the 2010 Blue Cross and Blue Shield of Texas (BCBSTX) Medicare Part D formulary was approved by the Centers for Medicare and Medicaid Services (CMS). As with all Medicare Part D drug plans, you can expect some changes for 2010.
Some of the changes were mandated by CMS (safety concerns, drugs that no longer meet CMS’s definition of a Part D medication) but others were a result of dynamic changes in the pharmaceutical marketplace. BCBSTX’s 2010 Medicare Part D formulary includes the addition of some new drug therapies as well as the migration to some important generic equivalents that became available in 2009.
A copy of the 2010 formulary will be included in the annual notice of change (ANOC) sent to all current members of BCBSTX’s Medicare Part D plans. In addition, individual member letters were mailed in late November 2009, alerting them to the 2010 formulary changes (removals, tier changes, new utilization management programs) affecting them.
A copy of the 2010 formulary is currently posted on the BCBSTX (www.bcbstx.com) Web site. Please refer to our list below for a handy reference to the top medications impacted by changes to the 2010 formulary that have the most potential to affect current members.
# | Formulary change | 2009 tier | 2010 tier | Description of formulary change | Formulary alternative |
1 | Omeprazole CAP 20 MG | 1 | 1 | Is on our formulary; however quantity limits may apply | On formulary, quantity limits may apply |
2 | FLOMAX CAP 0.4 MG | 2 | 3 | Is on our formulary, but will be covered in a higher cost tier | On formulary, higher tier |
3
| TOPROL XL TAB 25, 50, 100, 200 MG
| 3 | Not on formulary
| Is not covered on our 2010 formulary, as there are generic equivalents and/or generic alternatives available. When you choose generic drugs, you get prescription medications that are:
| Not on formulary, generic(s) available |
4
| Propoxyphene - N/APAP TAB 50/325, 100/500, 100/650 MG | 1 | Not on formulary | Is not covered on our 2010 formulary | ibuprofen, naproxen, acetaminophen w/ codeine, hydrocodone/acetaminophen |
5 | COZAAR TAB 25, 50, 100 MG | 2 | 3 | Is on our formulary, but will be covered in a higher cost tier | On formulary, higher tier |
6 | COMBIVENT AER | 2 | Not on formulary | Is not covered on our 2010 formulary | Check with your doctor |
7 | COSOPT SOL 2-0.5%OP | 3 | Not on formulary | Is not covered on our 2010 formulary, as there are generic equivalents and/or generic alternatives available. When you choose generic drugs, you get prescription medications that are:
| Not on formulary, generic(s) available |
8 | HYZAAR TAB 50-12.5, 100-12.5, 100-25 MG | 2 | 3 | Is on our formulary, but will be covered in a higher cost tier | On formulary, higher tier |
9 | Carisprodol TAB 350 MG, ASA/COD TAB | 1 | Not on formulary | Is not covered on our 2010 formulary | cyclobenzaprine, methocarbamol, tizanidine |
10 | LUMIGAN SOL 0.03% | 3 | Not on formulary | Is not covered on our 2010 formulary | Travatan, Travatan Z, Xalantan |
11 | Colchicine TAB 0.6 MG | 1 | Not on formulary | Is not covered on our 2010 formulary | Colcrys |
12 | ARIMIDEX TAB 1 MG | 2 | 3 | Is on our formulary, but will be covered in a higher cost tier | On formulary, higher tier |
13 | DEPAKOTE TAB 125, 250, 500 MG DR; SPR CAP 125 MG | 3 | Not on formulary | Is not covered on our 2010 formulary, as there are generic equivalents and/or generic alternatives available. When you choose generic drugs, you get prescription medications that are:
| Not on formulary, generic(s) available |
14 | KEPPRA TAB 250, 500, 750, 1000 MG; SOL 100 MG/ML | 2 | Not on formulary | Is not covered on our 2010 formulary, as there are generic equivalents and/or generic alternatives available. When you choose generic drugs, you get prescription medications that are:
| Not on formulary, generic(s) available |
15 | TOPAMAX TAB 25, 50, 100, 200 MG | 3 | Not on formulary | Is not covered on our 2010 formulary, as there are generic equivalents and/or generic alternatives available. When you choose generic drugs, you get prescription medications that are:
| Not on formulary, generic(s) available |
16 | ALPHAGAN P SOL 0.15% | 3 | Not on formulary | Is not covered on our 2010 formulary | brimonidine 0.2% ophthalmic |
17 | NULYTELY SOL | 2 | Not on formulary | Is not covered on our 2010 formulary, as there are generic equivalents and/or generic alternatives available. When you choose generic drugs, you get prescription medications that are:
| Not on formulary, generic(s) available |
18 | FEMARA TAB 2.5 MG | 2 | 3 | Is on our formulary, but will be covered in a higher cost tier | On formulary, higher tier |
19 | Dicyclomine TAB 20 MG, CAP 10 MG, SOL 10 MG/5 ML | 1 | Not on formulary | Is not covered on our 2010 formulary | Check with your doctor |
20 | XOPENEX HFA AER | 2 | Not on formulary | Is not covered on our 2010 formulary | PROAIR HFA, VENTOLIN HFA |
21 | ACULAR LS SOL 0.4%; SOL 0.5% OP | 2 | 3 | Is on our formulary, but will be covered in a higher cost tier | On formulary, higher tier |
22 | TOBRADEX SUS OP | 2 | Not on formulary | Is not covered on our 2010 formulary, as there are generic equivalents and/or generic alternatives available. When you choose generic drugs, you get prescription medications that are:
| Not on formulary, generic(s) available |
23 | VALTREX TAB 500 MG, 1 GM | 2 | 3 | Is on our formulary, but will be covered in a higher cost tier | On formulary, higher tier |
24 | TRUSOPT SOL 2% OP | 2 | Not on formulary | Is not covered on our 2010 formulary, as there are generic equivalents and/or generic alternatives available. When you choose generic drugs, you get prescription medications that are:
| Not on formulary, generic(s) available |