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Important change for the coverage of Adderall XR®

September 28, 2012

As new medications become available in the marketplace, we regularly review the prescription drug coverage of our members to make sure they are receiving high quality benefits while minimizing their costs wherever possible. For those providers who have prescribed Adderall XR, you may already be aware there is a generic equivalent available in the marketplace. In most cases, there is a cost savings to members when obtaining a generic. Unfortunately, as a result of ongoing supply issues, the generic equivalent for Adderall XR may not be available at the pharmacy. This can lead to delays in filling the medication and may result in higher costs for your patients. To help alleviate this issue, we are implementing a temporary change to the coverage of Adderall XR for commercial members who have a copay program for their prescription coverage (not a deductible drug plan*). Beginning November 1, 2012, and running through December 31, 2013, brand Adderall XR will be moved to our formulary's Tier 1 or generic copayment level. This means that during this time period, if your patients are currently taking the generic equivalent of Adderall XR, brand Adderall XR will be available at the same copayment that they currently pay for the generic version. Beginning November 1, 2012, your patients' participating pharmacy will automatically substitute their prescription with brand Adderall XR without an increase in the copayment amount. If you have any questions about this change in coverage, please call Customer Service at 1-800-ASK-BLUE or your Network Coordinator.

*This special limited-time program does not apply to members who have a deductible prescription drug program, discount card plans, or co-insurance plans. For all other members, starting on January 1, 2014, brand Adderall XR will become a non-preferred drug and will move to formulary Tier 3 (highest copay level). Therefore, effective January 1, 2014, to reduce members? out-of-pocket expense, prescriptions for Adderall XR should be filled with the generic equivalent. Members will continue to pay the same Tier 1 or generic copayment (lowest copay level).


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