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

January 2016

Specialty Pharmacy Program Updates


Harvard Pilgrim’s Specialty Pharmacy Program has added the following medications for both the Premium and Value formularies.

Name Indication Coverage Available From

Lonsurf (trifluridine and tipiracil) 

Lonsurf is a combination of trifluridine, a nucleoside metabolic inhibitor, and tipiracil, a thymidine phosphorylase inhibitor, indicated for the treatment of patients with metastatic colorectal cancer who have been previously treated with fluoropyrimidine-, oxaliplatin- and irinotecan-based chemotherapy, an anti-VEGF biological therapy, and if RAS wild-type, an anti-EGFR therapy. Pharmacy Accredo

Repatha (evolocumab) 

Repatha is a PCSK9 (proprotein convertase subtilisin kexin type 9) inhibitor antibody indicated as an adjunct to diet and:

  • Maximally tolerated statin therapy for treatment of adults with heterozygous familial hypercholesterolemia (HeFH) or clinical atherosclerotic cardiovascular disease (CVD), who require additional lowering of LDL-C 
  • Other LDL-lowering therapies (e.g., statins, ezetimibe, LDL apheresis) in patients with homozygous familial hypercholesterolemia (HoFH) who require additional lowering of LDL-C.

Pharmacy  Walgreens Specialty Pharmacy

Harvard Pilgrim’s Specialty Pharmacy Program has added the following medications to the Premium formularies only.

Name Indication Coverage Available From

ProThelial (polymerized sucralfate malate) 

ProThelial is paste that forms a protective layer over the oral mucosa by adhering to the mucosal surface and is used in the management of mouth lesions.  Pharmacy Accredo

Ravicti
(glycerol phenylbutyrate) 

Ravicti is indicated for use as a nitrogen-binding agent for chronic management of adult and pediatric patients =2 years of age with urea cycle disorders (UCDs) who cannot be managed by dietary protein restriction and/or amino acid supplementation alone.

Pharmacy Accredo

Zarxio
(filgrastim-sndz)  

Zarxio, a leukocyte growth factor, is the first biosimilar agent approved by the FDA.  It shares 5 of the 6 indications for which the originator product, Neupogen, is approved. The indications shared are: patients with cancer receiving myelosuppressive chemotherapy; patients with acute myeloid leukemia receiving induction or consolidation chemotherapy; patients with cancer undergoing bone marrow transplantation; patients undergoing autologous peripheral blood progenitor cell collection and therapy; patients with severe chronic neutropenia. Pharmacy Accredo

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