A formulary is a list of medications covered by BCBSAZ Advantage (Medicare Advantage is a medical insurance plan for seniors) and is considered to be a necessary part of a quality treatment program. To view this list in it’s entirety please visit their web site for more information: https://www.azbluemedicare.com/File%20Library/PDF/2013/BHP_14105000_G_EFF04012014_Comprehensive_FINAL.pdf.
BCBSAZ Advantage will generally cover the drugs listed in their formulary as long as the drug is medically necessary, the prescription is filled at a network pharmacy, and other plan rules are followed.
Medications may be added or removed during the year. If they remove drugs from the formulary or add restrictions to the drug, such as prior authorization, quantity limits and/or step therapy, or move a drug to a higher level in the formulary, BCBSAZ will notify members who take the drug at least 60 days before the change becomes effective. They may also notify members when they request a refill, at which time they would receive a 60-day supply of the drug. If the Food and Drug Administration (FDA) deems a drug on our formulary to be unsafe or the drug’s manufacturer removes the drug from the market, BCBSAZ will immediately remove the drug from our formulary and provide notice to members who take the drug.
The 2014 Blue MedicareRxsm (PDP) Enhanced and Value formularies have been updated and current PDFs of the English and Spanish formularies are now available on www.YourAZMedicareSolutions.com. The April drug changes are also in the online formulary search tool on the website. Formulary changes will be incorporated into the formulary and communicated each month. Below for your information are the April drug changes made to each formulary.
Blue MedicareRx Value formulary changes
|
TRADE NAME (generic name) or generic name |
Brand/ Generic Product |
Effective Date |
Nature of Change |
Description of Change |
Drug Alternative |
|
ERWINAZE (asparaginase Erwinia chrysanthemi) for inj, 10,000 units |
Brand |
3/1/14 |
Addition |
Tier 4. |
Not applicable |
|
APTIOM (eslicarbazepine) tabs, 200 mg, 400 mg, 600 mg, 800 mg |
Brand |
3/2/14 |
Addition |
Tier 4. |
Not applicable |
|
KUVAN (sapropterin) oral powder, 100 mg |
Brand |
3/9/14 |
Addition |
Tier 4. Prior authorization applies. |
Not applicable |
|
telmisartan/ hydrochlorothiazide tabs, 40-12.5 mg, 80-12.5 mg, 80-25 mg |
Generic |
3/9/14 |
Addition |
Tier 2. Quantity limits apply. First generic for Micardis HCT. |
Not applicable |
|
ibandronate inj, 3 mg/3 mL |
Generic |
3/16/14 |
Addition |
Tier 2. First generic for Boniva inj. |
Not applicable |
|
atovaquone susp, 750 mg/5 mL |
Generic |
3/23/14 |
Addition |
Tier 4. First generic for Mepron. |
Not applicable |
|
AZATHIOPRINE for inj, 100 mg |
Brand |
6/23/14 |
Removal |
Manufacturer has discontinued marketing this drug. |
Consult Prescriber |
Blue MedicareRx Enhanced formulary changes
|
TRADE NAME (generic name) or generic name |
Brand/ Generic Product |
Effective Date |
Nature of Change |
Description of Change |
Drug Alternative |
|
griseofulvin microsize tabs, 500 mg |
Generic |
1/1/14 |
Addition |
Tier 2. |
Not applicable |
|
ERWINAZE (asparaginase Erwinia chrysanthemi) for inj, 10,000 units |
Brand |
3/1/14 |
Addition |
Tier 4. |
Not applicable |
|
APTIOM (eslicarbazepine) tabs, 200 mg, 400 mg, 600 mg, 800 mg |
Brand |
3/2/14 |
Addition |
Tier 4. |
Not applicable |
|
KUVAN (sapropterin) oral powder, 100 mg |
Brand |
3/9/14 |
Addition |
Tier 4. Prior authorization applies. |
Not applicable |
|
telmisartan/hydrochlorothiazide tabs, 40-12.5 mg, 80-12.5 mg, 80-25 mg |
Generic |
3/9/14 |
Addition |
Tier 2. Quantity limits apply. First generic for Micardis HCT. |
Not applicable |
|
ibandronate inj, 3 mg/3 mL |
Generic |
3/16/14 |
Addition |
Tier 2. First generic for Boniva inj. |
Not applicable |
|
naloxone inj, 0.4 mg/mL |
Generic |
3/16/14 |
Cost Share Reduction |
Change to Tier 2 (was 4). |
Not applicable |
|
atovaquone susp, 750 mg/5 mL |
Generic |
3/23/14 |
Addition |
Tier 2. First generic for Mepron. |
Not applicable |
|
allopurinol for inj, 500 mg |
Generic |
6/23/14 |
Removal |
Manufacturer has discontinued marketing this drug. |
Consult Prescriber |
|
AZATHIOPRINE for inj, 100 mg |
Brand |
6/23/14 |
Removal |
Manufacturer has discontinued marketing this drug. |
Consult Prescriber |
