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

May 2013

Pharmacy Updates 


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.

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