Select Drug Formulary Update

Beginning January 1, 2009, AmeriHealth will make some changes to the Select Drug Program^®.

 

We would like to provide you with a list of our most recent changes to the drug formulary and some updates to our support of the safe prescribing of drugs.

Updates to the formulary and safe prescribing procedures

Our formulary is the key to the Select Drug Program. The formulary includes all generic drugs and a defined list of brand drugs — all of which have been selected for their medical effectiveness, safety, and value.

 

To ensure the continued effectiveness of the drugs on our formulary, as well as of our procedures for safe prescribing, the Pharmacy and Therapeutics Committee conducts regular reviews. The Pharmacy and Therapeutics Committee is composed primarily of practicing physicians and pharmacists in this area. As a result of the committee’s recent reviews, we’re implementing the following changes:

• additions of generic drugs to the formulary;
• addition and deletion of brand drugs to or from the formulary;
• additions to our list of drugs that require the doctor to obtain prior authorization.  

 

Click here to view a list of changes

Click here to view the complete formulary guide – effective  January 1, 2009

 

Please note: Brand drugs removed from the formulary will now be covered at the highest non-formulary
cost-sharing level.

Coverage update to ProAir HFA

Currently, AmeriHealth covers ProAir  HFA, an asthma inhaler, at the generic cost-sharing level.
To more appropriately reflect the manufacturer’s classification of this drug as a brand-name medication, AmeriHealth will be covering ProAir HFA at the brand-formulary cost-sharing level effective January 1, 2009.

Communicating to customers

All employer groups and members with Select Drug Program coverage will be notified of these changes in the winter issue of Update magazine. Comprehensive Major Medical members who do not receive Update will receive a letter notifying them of these changes. In addition, members who are directly affected by the changes detailed above will receive a letter with additional information and instructions.

 

We will urge members who are affected by the removal of a drug to contact their doctor to discuss formulary alternatives, including the use of generic drugs. If a doctor decides that an alternative medication is appropriate, the member will need to ask for a new prescription for that medication.

 

If you have questions, please contact your AmeriHealth Broker Representative.