Effective immediately, Harvard Pilgrim is now covering the medication Taltz with prior authorization. In March, the U.S. Food and Drug Administration approved Taltz, which is administered by injection, for the treatment of moderate-to-severe plaque psoriasis in adults. Taltz is covered on the Premium formularies only, at the highest tier (i.e. Tier 3 on the 3-Tier and Tier 4 on the 4-Tier Premium formularies). The drug has a quantity limit of four syringes per 28-day supply.
Harvard Pilgrim is requiring prior authorization to ensure the cost-effective and appropriate use of Taltz. Harvard Pilgrim’s Taltz Clinical Review Criteria detail the requirements that must be met in order to obtain prior authorization. To request prior authorization, please complete the Taltz Medication Request Form and fax it to MedImpact Healthcare Systems at 888-807-6643. For more information, refer to the Pharmacy section of Harvard Pilgrim’s provider website.