State Health Plan Launches New Pharmacy Prior Authorization Programs Beginning November 1, 2010
On November 1, 2010, the State Health Plan will begin a set of new pharmacy prior authorization programs. The Plan is implementing the programs to ensure appropriate medication utilization and to avoid any potential misuse. The programs cover the following classes of medications:
- Androgens and anabolic steroids, including oral, topical and injectable products. The products include: testosterone gel (Androgel®, Testim®); testosterone transdermal system (Androderm®); testosterone injection (Depo-Testosterone®); oxymetholone tablets (Anadrol-50®); and oxandrolone tablets (Oxandrin®).
- Central nervous system (CNS) stimulants, including generic and brand products. These products include: amphetamine/dextroamphetamine combinations (Adderall®, Adderall XR®); dexmethylphenidate (Focalin®, Focalin XR®); dextroamphetamine (Dexedrine®); lisdexamfetamine (Vyvanse®); methamphetamine (Desoxyn®); methylphenidate (Ritalin®, Methylin®, Methylin ER®, Ritalin SR®, Ritalin LA®, Metadate CD®, Metadate ER®, Concerta®); methylphenidate transdermal system (Daytrana®); atomoxetine (Strattera®); and guanfacine extended-release tablet (Intuniv®).
- Solodyn® (minocycline extended-release tablets) for the brand product Solodyn only. Generic minocycline products will not require a coverage review.
- Topical diclofenac products. These products include Flector® Patch (diclofenac epolamine 1.3%); Pennsaid® Topical Solution (diclofenac sodium 1.5%); and Voltaren® Gel (diclofenac sodium 1%).
You or your provider can request a coverage review by calling Medco toll-free at 800-417-1764, 8 a.m. to 9 p.m., Eastern Time, Monday through Friday. If the review is approved, you will pay the appropriate copay for the prescription. If approval is not obtained after November 1, 2010, you will be responsible for the entire cost of the prescription.
For additional information, click on the drug classes listed above or please contact Medco Member Services at 800-336-5933.