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Prescription drug updates

March 1, 2012

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For members enrolled in an IBC 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 drugs was effective at the time the drugs became available in the marketplace:

Brand drug

Generic drug

Drug category

Effective date

Ferriprox®

Not available

Miscellaneous

November 23, 2011

JakafiTM

Not available

Cancer

November 18, 2011

Effective April 1, 2012, the following 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:

Brand drug

Generic drug

Drug category

Copegus®

ribavarin

Stomach, Ulcer, & Bowel Meds

Peg-Intron®

Not available

Stomach, Ulcer, & Bowel Meds

Pegasys®

Not available

Stomach, Ulcer, & Bowel Meds

Rebetol®

ribavarin

Stomach, Ulcer, & Bowel Meds

RibaPak®

ribavarin

Stomach, Ulcer, & Bowel Meds

Ribasphere®

ribavarin

Stomach, Ulcer, & Bowel Meds

RibaTab®

ribavarin

Stomach, Ulcer, & Bowel Meds

Drugs with quantity limits

Effective April 1, 2012, quantity limits will be added for the following drugs:

Brand drug

Generic drug

Quantity limit (per 30 days)

Aciphex®

Not available

30 tabs

DexilantTM

Not available

30 caps

Nexium®

Not available

30 caps, packets

Prevacid®

lansoprazole

30 caps, tabs

Prilosec®

omeprazole

30 caps, tabs, packets

Protonix®

pantoprazole

30 tabs, packets

Zegerid®

Not available

30 caps, packets

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