Harvard Pilgrim’s Clinical Pharmacy program has two updates for providers this month.
Medications Now Requiring Prior Authorizations
Effective immediately, Harvard Pilgrim has implemented a prior authorization requirement for the following medications.
- Onfi (clobazam): Onfi is used along with other medicines to treat seizures associated with Lennox-Gastaut syndrome (LGS) in adults and children over
2 years of age. Harvard Pilgrim is requiring a prior authorization to ensure Onfi is used for appropriate patients only.
- Fulyzaq (crofelemer): Fulyzaq is an anti-diarrheal indicated for the relief of the symptoms of non-infectious diarrhea in adult patients with HIV/AIDS who are on anti-retroviral therapy. Harvard Pilgrim is requiring a prior authorization to reserve this unique medication for a select patient population.
Proventil HFA Tier Change
Effective June 15, 2013, Harvard Pilgrim is reassigning Proventil HFA (albuterol sulfate) from Tier 2 to Tier 3 (Tier 4 for 4-Tier formulary members). ProAir HFA and Ventolin HFA will remain available at a Tier 2 (Tier 3 for 4-Tier formulary members) copayment.
For the most up-to-date pharmacy benefit information—including lists of covered drugs, medications that are not covered, and medications that require prior authorization or for which coverage is limited, visit Harvard Pilgrim’s pharmacy page.