After receiving input from physician leaders, Harvard Pilgrim has decided to make selected medical infusible drugs available through the Specialty Pharmacy Program once again. The drugs that can be ordered through the Specialty Pharmacy Program are:
- Lupron Depot
- Sandostatin/Sandostatin LAR (octreotide)
As part of an effort to contain costs while having minimal impact on providers, on September 15, 2012, Harvard Pilgrim removed the option to obtain these medications from the Specialty Pharmacy Program; instead, they were available only through the medical buy-and-bill option.
Harvard Pilgrim’s aim was to find a means to reduce cost without limiting access to expensive but useful medications. However, after implementing this new policy, Harvard Pilgrim learned from physicians that it created operational and financial challenges in their practices.
"Upon hearing your concerns, we decided, effectively immediately, to rescind this policy,” explains Michael Sherman, M.D., Senior Vice President and Chief Medical Officer at Harvard Pilgrim. “While we all want lower costs, we recognize that it is critical that we work together, and the feedback we received helped us understand that this policy created unforeseen challenges for the physician community."
You may now obtain these medications for your Harvard Pilgrim patients directly from ICORE Healthcare by calling (866) 554-2673. If you have any questions about the reimbursement for these medications, please contact the Provider Service Center at (800) 708-4414.