The FDA approved the first generic versions of Cymbalta (duloxetine delayed-release capsules) in December. As a result, effective December 12, 2013, generic duloxetine is covered at Tier 1 for the 3-Tier formulary and Tier 2 for the 4-Tier formulary, while branded Cymbalta was moved to Tier 3 for the 3-Tier formulary and Tier 4 for the 4-Tier formulary.
Also, effective January 10, 2014, Harvard Pilgrim has revised our prior authorization guidelines as follows:
- Coverage of branded Cymbalta requires trial and failure of generic duloxetine
- Prior authorization criteria for neuropathic pain agents (Lyrica, Savella) now includes generic duloxetine as a first-line therapy
- Prior authorization criteria for brand name antidepressants now includes generic duloxetine as a first-line therapy
To obtain authorization for branded Cymbalta, please complete the appropriate Medication Request Form and fax it back to MedImpact Healthcare Systems at
For more information, visit Harvard Pilgrim’s pharmacy page.