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New drugs added to the Exclusive Specialty Drug List, starting January 1, 2013October 4, 2012
As you may know, our health plans include a specialty pharmacy program. Specialty pharmacies provide medicine to people with long-term health conditions, such as multiple sclerosis, cancer and rheumatoid arthritis. Specialty drugs come in different forms. Some need to be injected, infused or inhaled. And these drugs often need special handling and storage, like refrigeration.
These drugs are included on the Exclusive Specialty Drug List. Members in Individual plans with specialty prescription drug benefits and members in fully insured or administrative services only (ASO) groups with an exclusive specialty pharmacy benefit should get their specialty drug prescriptions filled at CuraScript, our preferred specialty pharmacy. Members also may use another pharmacy in the specialty pharmacy network.
On January 1, 2013, we’re adding new drugs to the Exclusive Specialty Drug List
The Food and Drug Administration (FDA) approves new specialty drugs that come out on the market. We’ll be adding over 250 of these new drugs to our list on January 1, 2013.
What this means to members taking the drugs we’ll be adding to the list
Members who are getting any of these specialty drugs at retail pharmacies will receive a letter. We’re letting them know they should move these prescriptions to CuraScript (or another in-network specialty pharmacy where appropriate) before January 1, 2013. If members keep using retail pharmacies for their specialty drugs after January 1, they may have to pay higher out-of-pocket costs. They may even have to pay the full cost of the drug.
Why we’re adding new specialty drugs to the list
By updating our list to include new drugs, members with long-term, complex health conditions can take advantage of the benefits of our specialty pharmacy program. These include:
- Delivery of their specialty drug right to their home.
- One-on-one service from a Pharmacy Care Advocate.
- 24/7 phone access to a registered nurse or pharmacist.
- Phone calls that remind members when it’s time for a refill.
- Order refills right from our website.
- A special nursing program that members can join for certain health conditions. The program helps members stick to their drug routines and helps them avoid possible side effects.
Here’s the Exclusive Specialty Drug List updated with the new drugs we’ll be adding.
If you have any questions, please contact your sales representative.