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

April 2019

Pharmacy and Therapeutics Committee Meeting Update


At the March 4, 2019 meeting, the Harvard Pilgrim Pharmacy & Therapeutics Committee reviewed the medications below and decided the following:

P&T Committee Review and Decisions

Name

Indication

Decision

Epidiolex (cannabidiol)

Used to treat seizures associated with Lennox-Gastaut syndrome or Dravet syndrome in patients age 2 and older.

• Premium and Value formularies: Moved to non-preferred brand with prior authorization

• Medicare Advantage Formulary: Remains at specialty tier

Lucemyra (lofexidine)

Used to mitigate the symptoms of opioid withdrawal to facilitate abrupt opioid discontinuation in adults.

• Premium and value formularies: Moved to non-preferred brand with step requirement

• Medicare Advantage formulary: Moved to specialty tier

Qbrexza (glycopyrronium)

Used topically to treat excessive underarm sweating in patients age 9 or older.

• Premium and value formularies: Moved to non-preferred brand with step requirement

• Medicare Advantage: Not eligible for coverage under Part D as the manufacturer does not have a signed discount agreement with CMS (labeler list)

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