Prescription drug updates

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Prescription drug updates

December 1, 2011

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For members enrolled in an AmeriHealth prescription drug program, prior authorization and quantity limit requirements will be applied to certain drugs. 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 U.S. Food and Drug Administration for a particular drug. The most recent updates are reflected below.

Drugs requiring prior authorization

The prior authorization requirement for the following non-formulary drugs was effective at the time the drugs became available in the marketplace:

Brand drug	Generic drug	Drug category	Effective date
Brilinta^TM	Not available	Heart, Blood Pressure, & Cholesterol	October 4, 2011
Firazyr?	Not available	Heart, Blood Pressure, & Cholesterol	August 26, 2011
Gralise^TM	Not available	Pain, Nervous System, & Psych	August 19, 2011
Horizant^TM	Not available	Pain, Nervous System, & Psych	July 27, 2011
Incivek^TM	Not available	Antibiotics and Other Drugs Used for Infection	August 8, 2011
Lazanda?	Not available	Pain, Nervous System, & Psych	September 30, 2011
Orencia? SQ	Not available	Bones, Joints, & Muscles	October 4, 2011
Victrelis^TM	Not available	Antibiotics and Other Drugs Used for Infection	August 8, 2011
Xalkori?	Not available	Cancer & Organ Transplant Drugs	September 2, 2011
Xarelto?	Not available	Heart, Blood Pressure, & Cholesterol	August 29, 2011
Zelboraf?	Not available	Cancer & Organ Transplant Drugs	August 17, 2011

The following non-formulary drugs will be added to the list of drugs requiring prior authorization. Members taking these drugs immediately prior to the effective date are not affected:

Effective December 1, 2011.