Harvard Pilgrim Health Care Home
  HPHConnect
 
  Learn more.
  Sign up for HPHConnect.
Medical Management
E-Transactions
HPHConnect
Pharmacy
For Your Patient
News Center
Network Matters
Newsletter Archives
Newsletter Registration
Newsroom
Office Support
Products
Provider Manual
Medicare Advantage
Research & Teaching
Resources & Links
 
Print    Text Size

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

August 2016

Harvard Pilgrim Preferred Insulin Products


Effective October 1, 2016, Harvard Pilgrim is designating preferred status to certain insulin medications indicated for the treatment of diabetes. Humulin (short- and intermediate-acting) and Humalog (rapid-acting) will become Harvard Pilgrim’s preferred insulin products on the Premium formulary. This same change will take effect on the Value formulary as of January 1, 2017.

If you have patients with diabetes who are prescribed NovoLog, Novolin, or ReliOn rapid-, short-, or intermediate-acting insulins, please be aware that they will have to pay a higher copayment for these insulins as of the October 1 effective date. While the Humulin and Humalog products will remain at their current tiers, their equivalent NovoLog, Novolin, and ReliOn products will be moving to Tier 4 on the 4-Tier Premium formulary. Coverage of long-acting insulins will remain unchanged.

Additionally, as of October 1, Harvard Pilgrim will require prior authorization for the coverage of NovoLog, Novolin, and ReliOn rapid, short-, or intermediate-acting insulin products on the Premium formulary. Harvard Pilgrim clinical review criteria, which will detail the requirements that must be met in order to obtain prior authorization for these products, are being created and will be posted to our website by October 1.

Harvard Pilgrim will require prior authorization for the following NovoLog, Novolin, and ReliOn insulin products on the Premium formulary:

• Novolin N

Relion Novolin R

NovoLog

• Relion Novolin N

Novolin 70-30

NovoLog FlexPen

• Novolin R

Relion Novolin 70-30

NovoLog Mix FlexPen

The comparable Humalog and Humulin insulin products, listed below, will not require a prior authorization and will be covered at the preferred brand tier:

• Humulin N/KwikPen

Humulin 70-30/KwikPen 

Humalog Mix50/50 KwikPen

• Humulin R/KwikPen

Humalog/KwikPen

Humalog Mix75/25 KwikPen

For more information, refer to the Pharmacy section of Harvard Pilgrim’s provider website.

Email this article to a colleague   


Network Matters Archives

Download printer-friendly version

HPHCURRENT EVENTS

New Publication on Healthy Eating For Older Adults

CLINICIAN CORNER

Updated Coverage Criteria for Hepatitis C Drugs

Harvard Pilgrim Preferred Insulin Products

Prior Authorization Required for Tresiba

Reminder: Co-Prescribing Naloxone Products With Opioids

Harvard Pilgrim to Cover Hymovis With Prior Authorization

Behavioral Health Care During Transition to College

OFFICE ASSISTANT

Reminder: Use Participating Laboratory Providers

PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Vice President, Network Services

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator