Blue Cross and Blue Shield of Illinois

 

April 11, 2014

Pharmacy Program Changes Effective July 1, 2014

Standard Formulary Changes
Based on Prime’s National Pharmacy and Therapeutics Committee’s review of changes in the pharmaceuticals market, some revisions will be made to the standard Blue Cross and Blue Shield of Illinois (BCBSIL) formulary effective July 1, 2014.

Standard Formulary Deletions

Brand medication* moving to a higher out-of-pocket payment level effective July 1, 2014:

Non-formulary Brand1

Condition
Used for

Generic Formulary Alternative(s)1

Formulary Brand Alternative(s)1

Apokyn2

Parkinson’s Disease

amantadine caps, amantadine syrup, benztropine, bromocriptine, carbidopa/levodopa ext-release, entacapone, pramipexole, ropinirole, selegiline caps, selegiline tabs, trihexyphenidyl

Azilect

*Third-party brand names are the property of their respective owner.
1This list is not all inclusive. Other medications may be available in this drug class.
2The cost for specialty medications may vary. Please see benefit materials for more information.

Targeted mailings will be sent to members affected by this change per our usual process of notifying members at least 60 days prior to implementation.

Standard Formulary Dispensing Limit Changes
BCBSIL’s standard prescription drug benefit program includes coverage limits on certain medications and drug categories. Dispensing limits are based on FDA-approved dosage regimens and product labeling.

Effective July 1, 2014, dispensing limits will be added for the following drugs:

Drug Class and Medication*

Dispensing Limit

Hereditary Angioedema

    Firazyr

6 syringes/30 days

*Third-party brand names are the property of their respective owner.

For the most up-to-date list of drug dispensing limits, visit bcbsil.com.

Targeted mailings will be sent to members affected by changes in dispensing limits per our usual process of notifying members at least 60 days prior to implementation.

If you have questions regarding these changes, please contact your account representative.

 


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A Division of Health Care Service Corporation, a Mutual Legal Reserve Company,
an Independent Licensee of the Blue Cross and Blue Shield Association.