In April, the U.S. Food and Drug Administration approved the medication Nuplazid, making it the first-ever drug approved to treat hallucinations and delusions associated with psychosis experienced by some people with Parkinson’s disease. Effective immediately, Harvard Pilgrim will cover Nuplazid on the Premium formularies only at the highest tier (i.e., Tier 3 on the 3-Tier and Tier 4 on the 4-Tier) with prior authorization. Approvals are valid for a 12-month period, and the medication has a quantity limit of 60 tablets per 30-day supply.
Harvard Pilgrim’s Nuplazid Clinical Review Criteria detail the requirements that must be met in order to obtain prior authorization. To request prior authorization, please complete the Nuplazid 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.