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Provider Newsletter 2nd Quarter 2011

August 16, 2011

A summary of recent BCBSTX Medicare Part D formulary changes can be found below. This list is updated regularly (monthly) by our pharmacy provider Prime Therapeutics. For a complete listing and for future inquiries of recent Medicare Part D formulary changes for your BCBSTX members please follow the following instructions: 

a) https://www.myprime.com,

b) Click on ‘Find Drugs &Estimates’,

c)  Follow directions to a corresponding health plan (e.g. a) click on ‘BCBS Texas’, b) Part D Member? Click ‘YES’, c) click on ‘Blue MedicareRx (PDP)’

d) Click on hyperlink ‘Formulary Updates. Pdf’

e) You can also inquiry as to plan covered medications and network pharmacies as well as accessing the Blue MedicareRx Comprehensive Formulary.  A number of other useful informational sources that can be found at this website include: CY 2010 to CY 2011 formulary changes, Prior Authorization Criteria, Filing a Grievance, Transition policies, etc.

 

Generic name

(TRADE NAME)

BRAND Generic Product

Effective Date

Nature of Change

Comments

Diclofenac sodium DR tabs, 25mg

Generic

3.23.11

Cost Share

Reduction

  • Change to Tier 1 (was 3)

 

Latanoprost opt soln, 0.005%

 

Generic

3.27.11

Addition

  • Tier 1
  • First generic for XALANTAN
  • Quantity Limits apply

 

exemestane Tabs

25mg

Generic

4.10.11

Addition

  • Tier 1
  • First generic for AROMASIN

 

Lithium carbonate tabs 300mg

Generic

4.12.11

Cost Share

Reduction

 

  • Change to Tier 1 (was 3)

 

Disulfiram tabs, 250mg

Generic

4.17.11

Addition

  • Tier 1
  • First generic for ANTABUSE

 

Acetazolamide extended-release 12 hr caps 500mg

Generic

5.1.11

Addition

  • Tier 1
  • First generic for DIAMOX SEQUELS

 

Eplerenone tabs

25mg, 50mg

Generic

5.1.11

Addition

  • Tier 1
  • First generic for INSPRA

 

Letrozole tabs, 2.5mg

Generic

5.1.11

Addition

  • Tier 1
  • First generic for FEMARA

 

ANDROGEL PUMP (testosterone) transdermal gel, 20.25/mg/act

 

BRAND

5.8.11

Addition

  • Tier 2

 

bromfenac ophth soln, 0.09%

 

Generic

5.15.11

Addition

  • Tier 1
  •  First generic for XIBROM

 

Paroxetine hcl extended release 24 hr tabs, 37.5mg

Generic

5.22.11

Cost Share

Reduction

Utilization Manage-ment change

  • Change to Tier 1 (was 3)
  • Step Therapy NO longer applies
  • Quantity Limits continue to apply

 

Carbamazepine extended release 12 hr caps, 100mg, 200mg, 300mg

Generic

5.29.11

Addition

  • Tier 1
  • First generic for CARBATROL

 

Latanoprost ophth soln, 0.005%

 

Generic

6.1.11

Utilization Manage-ment change

  • Tier 1
  • Quantity Limits NO longer apply

 

XALANTAN (Latanoprost) ophth soln, 0.005%

 

BRAND

6.1.11

Utilization Manage-ment change

  • Tier 3
  • Quantity Limits NO longer apply

 

LUMIGAN (bimatoprost) ophth soln, 0.01%, 0.03%

BRAND

6.1.11

Utilization Manage-ment change

  • Tier 2
  • Quantity Limits NO longer apply
  •  

TRAVATAN. TRAVATAN Z (travoprost) ophth soln, 0.004%

 

BRAND

6.1.11

Utilization Manage-ment change

  • Tier 2
  • Quantity Limits NO longer apply

 

methylergonovine tabs, 0.2mg

Generic

6.19.11

Addition

  • Tier 1
  • First generic for METHERGINE

 

Triamcinolone nasal, 55mcg/spray

Generic

6.19.11

Addition

  • Tier 1
  • First generic for NASACORT AQ
  • Quantity Limits apply

 

Budesonide extended release 24 hr caps, 3mg

Generic

6.26.11

Addition

  • Tier 1
  • First generic for ENTOCORT EC

 

Levofloxacin oral soln, 25mg/ml; tabs, 250mg, 500mg, 750mg

 

Generic

6.26.11

Addition

  • Tier 1
  • First generic for LEVAQUIN

 

Leuprolide acetate (LUPRON DEPOT – 6 month) for inj kit,

45mg

 

BRAND

6.26.11

Addition

  • Tier 4