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New ADHD Drug and Reminder About July 1 Rx UM Changes

We want to inform you about a new ADHD drug, Zenzedi, and remind you of some new pharmacy utilization management requirements that will be effective August 1, 2013. 

Zenzedi

Zenzedi (dextroamphetamine sulfate) is a newly approved medication by the Food and Drug Administration, which will be available to commercial BCBSNC members as of June 28, 2013.  This medication treats ADHD and narcolepsy and as with other similar medications, it will be subject to review for quantity limitations for commercial members who participate in our UM programs.  This does not apply to State Health Plan, Federal Employee Program or Medicare Part D members.  The maximum daily dose for ADHD is 40 mg / day and for narcolepsy is 60 mg / day.  The updated ADHD fax form and criteria will be available online at www.bcbsnc.com/umdrug as of June 28. 

Liptruzet

On May 3, Liptruzet was approved by the Food and Drug Administration as a new statin medication to lower cholesterol.  Liptruzet is a combination of Zetia, which works to lower the absorption of cholesterol, and generic Lipitor, which works to reduce the production of cholesterol.  As with our other cholesterol-lowering products, this new medication will require prior review for commercial members who participate in our utilization programs. This does not apply to State Health Plan, Federal Employee Program or Medicare Part D members.  The detailed approval criteria for both of these medications can be found online at www.bcbsnc.com/umdrug

Xeljanz

Effective July 1, 2013, we will require that new BCBSNC patients prescribed Xeljanz, a new rheumatoid arthritis drug, must try Enbrel or Humira first. The updated fax form will be available online at www.bcbsnc.com/umdrug  as of June 28 for your convenience. 

July 1 Rx UM Changes

You can read more about the new pharmacy utilization management requirements for Xeljanz, as well as Firazyr, that will be effective on July 1 in our April 1 news item

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