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

July 2016

Specialty Pharmacy Update

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

Name Indication Coverage Available From

Aralast NP [alpha1-proteinase inhibitor (human)] 

Aralast NP is an alpha1-proteinase inhibitor used to treat emphysema in adults with an inherited alpha1-proteinase inhibitor deficiency. Medical Accredo

Venclexta (venetoclax) 

Venclexta is a BCL-2 inhibitor used to treat chronic lymphocytic leukemia (CLL) in patients with 17p deletion (as detected by an approved test) who have received at least one prior therapy. 

Pharmacy Diplomat 

Wilate [von Willebrand factor/coagulation factor VIII complex (human)] 

Wilate is a plasma-derived, highly purified concentrate of freeze-dried human von Willebrand factor (VWF) and coagulation factor VIII (FVIII). It is indicated for on-demand treatment and control of bleeding episodes, and perioperative management of bleeding in pediatric and adult patients with von Willebrand disease. 

Medical  Caremark

Xeljanz XR (tofacitinib citrate) 

Xeljanz XR is an extended-release formulation of tofacitinib citrate used to treat moderate to severe active rheumatoid arthritis in adults who have had an inadequate response to, or are intolerant of, methotrexate.

Pharmacy Accredo

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Substance Abuse Materials Now Available Online


Medical Policy Changes for Injectable and Infusible Drugs

Coverage of Vitamin B12 Screening and Testing

Coverage of Tumor Treatment Field Device for Glioblastoma

Briviact Covered With Prior Authorization

Nuplazid Covered With Prior Authorization

New Medical Policy for H. Pylori Testing

New Medical Policy for Nucala

Tier Increase for Apidra and Apidra SoloSTAR on the Premium Formulary

Tier Increase for Edecrin on the Premium Formulary

Diagnosing and Treating Depression in Older Adults

P&T Committee Meeting Update

Specialty Pharmacy Update


Reminder: Keep Panel Status and Demographic Information Up to Date


Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Vice President, Network Services

Annmarie Dadoly,

Joseph O'Riordan,

Kristin Edmonston,
Production Coordinator