IBC Flash

February 22, 2008

Select Drug Program^® Formulary Changes Effective 4/1/08

This is an update to inform you of changes we are making to the Select Drug Program^® formulary, notify you of an over-the-counter exclusion that will be applied to Zyrtec^® and Zyrtec-D 12 Hour^®, and provide you with information about a prior-authorization requirement that will soon apply to the medication Altabax^TM.

Changes to the formulary and safe-prescribing procedures

Key to the Select Drug Program is our formulary, which 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 and our procedures for safe prescribing, the Pharmacy and Therapeutics Committee conducts regular reviews. The Pharmacy and Therapeutics Committee is primarily composed of practicing area physicians and pharmacists. As a result of the committee’s recent reviews, we’re implementing several changes including:

• additions of generic drugs to the formulary;

• additions and deletions of brand drugs to or from the formulary;

• additions to our list of drugs that require a physician to obtain prior authorization.

Please note: The brand drugs being removed will now be covered at the highest non-formulary cost-sharing level.

Click here to view the list of formulary updates.

Altabax prior-authorization

Effective April 1, 2008, Altabax, which is a topical antibiotic, will require prior authorization. The purpose of prior authorization is to ensure that drugs are medically necessary and are being used appropriately. However, anyone taking Altabax immediately prior to the effective date may continue to receive it without obtaining prior authorization until May 31, 2008. After that date, the prior-authorization requirement will apply for any new prescriptions or refills.

Over-the-counter exclusions

Effective April 1, 2008, Zyrtec and Zyrtec-D 12 Hour, which are non-sedating antihistamines, will no longer be covered under prescription drug benefits because they are available over the counter. Over-the-counter drugs are standard exclusions from all Independence Blue Cross prescription drug programs. Zyrtec and Zyrtec-D 12 Hour can now be obtained over-the-counter at the retail cost of the medication.

Communicating to customers

All employer groups and members with Select Drug Program coverage will receive notification about these changes in the spring Update magazine. Members who are directly affected by the changes detailed above will receive a letter with additional information and instructions.

In addition, we will send members who have filled a prescription for Zyrtec or Zyrtec-D 12 Hour within the past 12 months a $5 coupon, courtesy of McNeil Consumer Healthcare. We hope that this will ease their transition to purchasing Zyrtec and Zyrtec-D 12 Hour over-the-counter.

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 a formulary medication is appropriate, the member will need to ask for a new prescription for the formulary medication.

If you have any questions, please contact your Independence Blue Cross account executive.

Thank you for your continued support. We are working hard to meet and exceed our customers’ needs, and you are an integral part of that process.

Click here to view the IBC group letter.

Click here to view the IBC targeted member letter.

Click here to view the IBC targeted member letter being sent to those affected by the Zyrtec changes.

Click here to view the IBC targeted member letter being sent to those affected by the Altabax changes.

Independence Blue Cross offers products directly, through its subsidiaries Keystone Health Plan East and QCC Insurance Company, and with Highmark Blue Shield. Independent licensees of the Blue Cross and Blue Shield Association.