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

March 2015

New Quantity Limits for Select Opioid Agents 


Effective May 15th, 2015, the following medications will now have quantity limits: Exalgo, hydromorphone ER, Nucynta ER, Opana ER, and oxymorphone ER.

Medication

Quantity Limit

Formularies

Exalgo (hydromorphone ER) 

60 tablets per 30 days 

Premium

hydromorphone ER (generic)

60 tablets per 30 days 

Premium & Value

Nucynta ER 60 tablets per 30 days  Premium & Value
Opana ER (oxymorphone ER) 90 tablets per 30 days  Premium
oxymorphone ER (generic) 90 tablets per 30 days Premium & Value

This month, Harvard Pilgrim will send letters to members who have filled prescriptions for any of these agents in the past three months notifying them of the change. Harvard Pilgrim has determined that members with a cancer diagnosis will not be subject to the quantity limit. If your patient has cancer and is taking one of these medications, you may submit an exception request by completing a Formulary Exception Request Form and faxing it to MedImpact Healthcare Systems at 888-807-6643.

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PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Richard Weisblatt PhD,
Senior Vice President, Provider Network

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator