Effective January 1, 2018, changes will be made to the AmeriHealth Select Drug Program® Formulary. The Select Drug Program is a formulary-based prescription drug benefit program available to commercial members. It includes all generic drugs and a defined list of brand-name drugs that have been approved by the U.S. Food and Drug Administration (FDA), chosen for formulary coverage based on their medical effectiveness, safety, and value. The Pharmacy and Therapeutics Committee reviews the formulary periodically to ensure its continued effectiveness.
In addition, new and updated prior authorization and quantity limit requirements will be applied to certain drugs for commercial members enrolled in an AmeriHealth prescription drug program. The purpose of prior authorization is to ensure that drugs are medically necessary and are being used appropriately. Quantity limits are designed to allow a sufficient supply of medication based upon the maximum daily dose and length of therapy approved by the FDA for a particular drug.
Please review the AmeriHealth New Jersey formulary changes and AmeriHealth Pennsylvania formulary changes that go into effect January 1, 2018. For additional information on pharmacy policies and programs, visit our websites for AmeriHealth New Jersey or AmeriHealth Pennsylvania.