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Updates to the specialty drugs covered under the pharmacy benefit

December 12, 2019

Effective January 1, 2020, Independence will be making changes to the following specialty pharmacy drugs covered under the pharmacy benefit:

Drugs that will be considered specialty pharmacy  Drugs that will no longer be considered specialty pharmacy

Ingrezza®

Repatha®

Rilutek®/Riluzole

Praluent®

Tiglutik™

Mercaptopurine

Cystadane Powder®

 

D-penamine

 

Ridaura®

 

Exjade®/Deferasirox

 

Alkeran®/Melphalan

 

Targretin® gel 1%

 

Specialty pharmacy drugs

Specialty pharmacy drugs covered under the pharmacy benefit are typically drugs that are administered by the patient. These may include, but are not limited to, drugs that are taken orally or administered by injection. Specialty drugs meet certain criteria, including:

  • drugs used to treat rare, complex, or chronic diseases;
  • drugs that have complex storage and/or shipping requirements;
  • drugs that require comprehensive patient monitoring and education.

Some members may see a change in their cost-share if their prescription drug formulary includes a specialty tier based on the Independence member’s prescription drug benefit design.

Specialty pharmacies

Specialty drugs are typically dispensed by specialty pharmacies. Members should contact their current pharmacy to determine if the pharmacy will continue to supply the drug(s) listed above. 

Learn more

If you have any questions concerning the specialty drugs covered under the pharmacy benefit, please contact FutureScripts®
at 1-888-678-7012.

FutureScripts is an independent company that provides pharmacy benefits management services.


This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of Independence Blue Cross. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.
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