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Changes to growth hormone prescribing procedures

November 30, 2012

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Effective January 1, 2013, for coverage under the terms of our commercial health plans*, prior authorization will not be issued for Humatrope? in the absence of a documented trial and failure of therapy with, or contraindication to, Norditropin?.

As of January 1, 2013, a new prior authorization will be required in order for members to receive Humatrope?. In addition, any existing authorizations for Humatrope? will no longer be valid as of January 1, 2013. Members who are currently taking Humatrope?, but who have a documented history of trial and failure of Norditropin?, will not be considered an exception. For members who have previously tried and failed Norditropin?, the documentation of such failure should be submitted along with your prior authorization request for coverage of Humatrope?. All coverage requests and prescription drug claims for Humatrope? for commercial members will be denied in the absence of a new prior authorization. This requirement for Humatrope? prior authorization applies to members starting, as well as those currently taking, Humatrope?.

Please note that even in circumstances where prior authorization is obtained for Humatrope?, members will be responsible for the highest non-formulary level of cost-sharing available under the terms of their plan.

Effects on existing Humatrope? prescriptions

Prescriptions now on file for commercial members on Humatrope? will require prior authorization effective January 1, 2013.

Recent approvals for Humatrope?

We recognize that certain members may have recently had a prior authorization issued for Humatrope?. Those prior authorizations are valid for one year. To reduce the administrative burden on you and your patients and to avoid disruption in therapy, Norditropin? will not require authorization for the period of coverage prior to January 1, 2013, that Humatrope? was authorized. However, patients will require a new prescription for Norditropin? in order for Norditropin? to be dispensed by the pharmacy. Submission of additional clinical information will not be necessary. Your IBC commercial patients will not experience a change to their cost-sharing obligation for Norditropin? (i.e., copayment, coinsurance, or deductible) as a result of this change.

If you have any questions related to this change, please call FutureScripts at 1-888-678-7012.

*Does not include Medicare Advantage HMO and PPO or other government programs.

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