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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

January 2017

Pharmacy & Therapeutics Committee Updates


At the December 5th, 2016 meeting, the Harvard Pilgrim Pharmacy & Therapeutics Committee reviewed three medications and decided the following:

P&T Committee Review and Decisions

Name

Description and Indication

Decision

Viberzi (eluxadoline) 

Viberzi is a mu-opioid receptor agonist indicated for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults.

  • Premium formulary: Added to preferred brand tier
  • Value formulary: Added to preferred brand tier
  • Medicare Advantage formulary: Continued coverage at Tier 5 (Specialty Tier)

Savaysa (edoxaban) 

Savaysa is a factor Xa inhibitor indicated to reduce the risk of stroke and systemic embolism (SE) in patients with nonvalvular
atrial fibrillation (NVAF).

  • Premium formulary: Continued coverage at non-preferred brand tier
  • Value formulary: Remains non-covered
  • Medicare Advantage formulary: Continued coverage at Tier 4

Ocaliva (obeticholic acid) 

Ocaliva is a farnesoid X receptor (FXR) agonist indicated for the treatment of primary biliary cholangitis (PBC) in combination with ursodeoxycholic acid (UDCA) in adults with an inadequate response to UDCA, or as monotherapy in adults unable to tolerate UDCA.

  • Premium formulary: Premium formulary: Continued coverage at non-preferred brand tier with prior authorization
  • Value formulary: Remains non-covered
  • Medicare Advantage formulary: Continued coverage at Tier 5 (Specialty Tier)

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