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Prior Review Required for Qsymia

Release Date: July 27, 2012

A new weight loss drug, Qsymia (phentermine and topiramate), was recently approved by the U.S. Food and Drug Administration (FDA) and is expected to be available on the market in the fourth quarter of 2012.  Qsymia is appropriate for use in conjunction with a reduced-calorie diet and exercise for chronic weight management. 

Once this medication becomes available on the market, Blue Cross and Blue Shield of North Carolina (BCBSNC) will place Qsymia on the prior review list to ensure appropriate and safe use. 

This prior review requirement applies to group and individual commercial members with pharmacy benefits through BCBSNC and group members who have drug utilization management programs.  This requirement does not apply to the State Health Plan (SHP), Federal Employee Program (FEP), or Blue MedicareSM members. 

Note: Please remember to verify the benefits for these plans, as other utilization requirements for this and other prescription drugs may apply.

If you have questions, please contact the Provider Blue LineSM at 1.800.214.4844.