2012 Pharmacy Changes at a Glance
Posted 02/02/12

NON-MEDICARE CHANGES

• 90 day supply
• Provigil/Nuvigil Quantity Duration Program (250mg/day of Nuvigil and 200mg(+)/day of Provigil)
• Rheumatoid Arthritis Step Therapy Program (Use of Cimzia or Simponi requires the failure of both Enbrel and Humira for rheumatoid arthritis; for Crohn’s disease, failure of Humira only)
• Adoption of Medco’s Self-Administered Injectable List (Most non-self-administered injectable drugs are now covered under the medical program)
• Specialty medication copay increase ($60.00 Preferred and $120.00 non-Preferred)
• $0.00 copay for prescription and OTC tobacco cessation medications
• Some OTC medications are covered with a prescription (ex:  aspirin, folic acid, etc.; age limits may apply)
• Fosamax D no longer Preferred (4/1/2012)
• Suboxone tablets no longer Preferred (4/1/2012)

MEDICARE CHANGES

• Initiation of mail service benefits (3/1/2012)
• Intranasal Steroid PA Program (generics only will be Preferred)
• Multiple Sclerosis PA and Quantity Limit Program (90 day limit)
• Oncology PA and Quantity Duration Program
• Provigil PA Program (90 day limit)
• Rheumatoid Arthritis PA and Quantity Duration Program (90 day limit)
• Oxycontin Step Therapy Program (new users must try and fail morphine sulfate ER)
• $0.00 copay for prescription and OTC tobacco cessation medications