Harvard Pilgrim Health Care Home
  HPHConnect
 
  Learn more.
  Sign up for HPHConnect.
Medical Management
E-Transactions
HPHConnect
Pharmacy
For Your Patient
News Center
Network Matters
Newsletter Archives
Newsletter Registration
Newsroom
Office Support
Products
Provider Manual
Medicare Advantage
Research & Teaching
Resources & Links
 
Print    Text Size

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

February 2018

P&T Committee Meeting Update


At the Dec. 4th, 2017 meeting, the Harvard Pilgrim Pharmacy & Therapeutics Committee reviewed two medications and decided the following:

P&T Committee Review and Decisions

Name

Indication

Decision

Trulance (plecanatide) 

Treatment of chronic idiopathic constipation.

• Premium formulary: continued coverage at non-preferred brand tier. Prior authorization is no longer required

• Value formulary: moved to non-preferred brand tier

• Medicare Advantage Formulary: moved to non-preferred brand tier

Emflaza (deflazacort)

Treatment of Duchenne muscular dystrophy (DMD) in patients 5 years of age and older.

• Premium formulary: continued coverage at the non-preferred brand tier, with prior authorization and quantity limit

• Value formulary: added to non-preferred brand specialty tier, with prior authorization and quantity limit

• Medicare Advantage formulary: remains non-formulary

Email this article to a colleague   


Network Matters Archives

Download printer-friendly version

HPHCURRENT EVENTS

Changes to Negative Balance and Refund Processes

Maximum Dosages for Medical Drugs

Reminder: Prior Authorization for Genetic Testing

Saheli Boston Can Help Meet the Needs of South Asian Patients

CLINICIAN CORNER

Prior Authorization for Diabetes Management Devices

Coverage of Exondys 51 with Prior Authorization

PCP Cardiac Medication Adherence Report

Member Blood Pressure Quiz

Endoscopic Sinus Surgeries Medical Review Criteria Updates

Lyme/Tick-Borne Diseases: Use of Parenteral Antibiotics Criteria

P&T Committee Meeting Update

Specialty Pharmacy Update

Members’ Rights and Responsibilities

HEDIS Spotlight: Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (IET)

OFFICE ASSISTANT

Reminder: Use the Correct Form for Provider Changes for Quicker Service

PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Senior Vice President, Network Strategy

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator