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).