Based on the availability of new prescription medications and the Prime’s National Pharmacy and Therapeutics Committee’s review of changes in the pharmaceuticals market, some revisions were made to the Blue Cross and Blue Shield of Texas (BCBSTX) Standard drug list and Generics Plus drug list that became effective on July 1, 2016.
Brand Medications Added to the Standard and Generics Plus Drug Lists, Effective July 1, 2016:
| Preferred Brand1 | Drug Class/Condition Used For |
| Adynovate | Hemophilia |
| Brilinta | DVT, Stroke and Embolism Prophylaxis |
| Coagadex | Hemophilia |
| Depen | Wilson’s Disease, Cystinuria |
| Narcan | Opiate Overdose |
| Uptravi | Pulmonary Arterial Hypertension |
Brand Medications Added to the Generics Plus Drug List, Effective July 1, 2016:
| Preferred Brand1 | Drug Class/Condition Used For |
| Eliquis | DVT, Stroke and Embolism Prophylaxis |
Utilization Management Program Changes
Effective July 1, 2016, several drug categories and/or targeted medications were added to the current Prior Authorization (PA) and Step Therapy (ST) programs for BCBSTX select members on standard pharmacy benefit plans.
Drug Categories Added to the Pharmacy PA Standard Programs, Effective July 1, 2016:
| Drug Category | Targeted Medication(s)1, 2 |
| Ophthalmic Immunomodulators | Restasis |
Targeted Drugs Added to Current Pharmacy PA Standard Programs, Effective July 1, 2016:
| Drug Category | Targeted Medication(s)1, 2 |
| Therapeutic Alternatives | Kadian, Northera, Onmel, Sporanox, Spritam, Zegerid, Zyflo/Zyflo CR |
Drug Categories Added to Current Pharmacy ST Standard Programs, Effective July 1, 20163:
| Drug Category | Targeted Medication(s)1, 2 |
| Atypical Antipsychotics | Abilify, Abilify Discmelt, Abilify Maintena, Aripiprazole ODT, Aristada, Clozaril, Fanapt, Fazaclo, Clozapine ODT, Geodon, Invega, Invega Sustenna, Invega Trinza, Latuda, Rexulti, Risperdal, Risperdal M-Tab, Risperdal Consta, Saphris, Seroquel, Seroquel XR, Versacloz, Zyprexa, Zyprexa Zydis, Zyprexa Relprevv |
For the most up-to-date drug list and list of drug-dispensing limits, visit the Pharmacy Program section of our website at bcbstx.com/provider.