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Prescription drug updates

November 30, 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 non-formulary drugs was effective at the time the drugs became available in the marketplace:

Brand drug

Generic drug

Drug category

Effective date

Bosulif?

Not available

Cancer

September 14, 2012

Xtandi?

Not available

Cancer

September 7, 2012

ZetonnaTM

Not available

Ear, Nose, Throat Medications

June 8, 2012

The following drugs will be added to the list of drugs requiring prior authorization for new prescriptions. Members taking these drugs immediately prior to the effective date are not affected.

Effective January 1, 2013.

Brand drug

Generic drug

Drug category

Extavia?

Not available

Biotechnology

Rebif?

Not available

Biotechnology

ZioptanTM

Not available

Eye Medications


Drugs with quantity limits

Quantity limits will be added for the following drugs:

Brand drug

Generic drug

Drug category

Quantity limit
(per 30 days)

Effective date

N/A

codeine 30mg/5ml solution

Pain, Nervous System, & Psych

1800 ml

December 1, 2012

BinostoTM

Not available

Bone, Joint, & Muscle

5 tabs

October 15, 2012

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