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New Pharmacy Alert for Overlapping Opioid Claims

Blue Cross and Blue Shield of North Carolina’s (Blue Cross NC) Concurrent Drug Utilization Review (CDUR) system has a new safeguard being implemented in retail pharmacies. Effective September 1, 2017, a prompt notifies pharmacists if claims overlap for an opioid analgesic and opioid dependence therapy (buprenorphine).

A message displayed on the claim screen alerts pharmacists that the prescribed medication may be contraindicated with opioid dependence therapy. CDUR require pharmacies to submit an override after the pharmacist verifies that the prescriber is aware of the opioid dependence therapy. As a result, prescribers may experience a period of increased inquiries from patients and pharmacies regarding the claims.

List of buprenorphine products that will result in an alert with any opioid analgesic claim:

  • Buprenorphine HCl sublingual tab (Subutex, generic)
  • Buprenorphine HCl-naloxone HCl sublingual film (Suboxone®)
  • Buprenorphine HCl-naloxone HCl sublingual tab (Zubsolv®, Suboxone®, generic)
  • Buprenorphine HCl-naloxone buccal film (Bunavail®)