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

October 2017

Specialty Pharmacy Program Updates

Harvard Pilgrim’s Specialty Pharmacy Program has added the following medications:

Name Indication Coverage Available From

Austedo (deutetrabenazine) 

Indicated for the treatment of chorea associated with Huntington’s disease.  Pharmacy  Limited Distribution Drug:  Cardinal Health Specialty Pharmacy

Emflaza (deflazacort)

A corticosteroid indicated for the treatment of Duchenne
muscular dystrophy (DMD) in patients 5 years of age and older.

Pharmacy Limited Distribution Drug:  U.S. Bioservices

To request prior authorization for Austedo or Emflaza, providers in Massachusetts should use the Massachusetts Standard Form for Medication Prior Authorization Requests. Providers in all other states should use the drug-specific Medication Request Forms, which are located in the “Pharmacy” section of our Provider website, along with the clinical coverage criteria. Completed forms should be faxed to MedImpact Healthcare Systems at 858-790-7100.

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