07/31/2024
Starting Oct. 1, 2024, coverage of Abiraterone Acetate will change for many of our commercial members with pharmacy benefits administered by Prime Therapeutics. These members will only have coverage for the CivicaScript® produced, low-cost generic version of Abiraterone Acetate 250 mg. This drug is only available through SortPak Pharmacy.
Zytiga and other generic versions of Abiraterone Acetate 250 mg will no longer be covered on the drug lists for our members with employer group or individual health plan benefits.
This change will not apply for some of our members until or after Jan. 1, 2025.
Send prescriptions to SortPak
Letters about this change will be sent to members with claims for Zytiga or other generic versions of Abiraterone Acetate 250 mg. The letter explains how to receive the medication from SortPak, including where to send the prescription.
If your patient receives this letter and asks for a new prescription, please e-prescribe or fax:
- SortPak Pharmacy, 124 S. Glendale Ave., Glendale, CA 91205
- NCPDP/NABP: 0524733, NPI: 1063407252
- Fax: 877-475-2382
- Phone: 877-570-7787
Why the change?
Our partnership with CivicaScript furthers our initiatives to make prescription drugs more affordable for our members. Lower cost generic drugs help lower members’ out-of-pocket costs and improve medication adherence.
Check eligibility and benefits
Treatment decisions are between you and your patients. Coverage is subject to the terms and limits of your patients’ benefit plans. Always check eligibility and benefits for each member at every visit. This step confirms membership and other details, such as prior authorization requirements and utilization management vendors, if applicable.
If your patients have questions about pharmacy benefits, they can call the number on the back of their member ID card, log in to Blue Access for MembersSM or visit MyPrime.com.
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The information mentioned here is for informational purposes only and is not a substitute for the independent medical judgment of a physician. Physicians are to exercise their own medical judgment. Pharmacy benefits and limits are subject to the terms set forth in the member’s certificate of coverage which may vary from the limits set forth above. The listing of any drug or classification of drugs is not a guarantee of benefits. Members should refer to their certificate of coverage for more details, including benefits, limitations, and exclusions.