BCBSNC Pharmacy Updates

June 6, 2018

 

Blue Cross and Blue Shield of North Carolina (BCBSNC) recently issued two important pharmacy updates. In some cases, members will not be notified individually by BCBSNC. An employee communication is included at the end that can be shared with members.

Generic Viagra now available
Effective June 8, 2018, generic Viagra is available without prior authorization due to cost reduction. Members currently taking Brand Viagra will receive direct communication about this from BCBSNC. Brand Viagra will move to brand tiers for Enhanced and Essential formulary members on July 1, 2018. This tier change will NOT be made for members on the Net Results formulary at this time.

Generic version of Welchol now available
Welchol is a medication for the treatment of high blood sugar and cholesterol. Because new-to-market generics are not priced significantly lower than the brand version for the first six months, Welchol will be treated as the preferred product on the Enhanced formulary only. Welchol will be moved to the generic tier so members are not charged more than if they received the generic.

A prior approval (PA) requirement was added for the generic, Colesevelam. Once the cost of the generic decreases, the PA requirement will be removed from the generic drug, and move brand Welchol to a higher tier on the Enhanced formulary.

Since both brand and generic products are in the same tier, members will still pay the same for these medications, however PA will not be required for brand Welchol. PA is required for the generic. This will make it easier for them to continue taking the brand medication.

Effective May 29, 2018 members on the Enhanced formulary will be required to use brand Welchol over generic Colesevelam. Brand Welchol will move tiers as noted:

•For members on the Enhanced four-tier formulary, brand Welchol will move from tier 2 to tier 1
•For members on the Enhanced five-tier formulary, brand Welchol will move from tier 3 to tier 2

Members were not notified about these changes. They should continue receiving the brand medication as they have been in the past, but at a reduced price. If they try to receive the generic, they will be told their provider needs to submit additional information to BCBSNC.

Members can find additional Pharmacy and formulary information on the Find a Drug (https://www.bluecrossnc.com/find-a-drug-or-pharmacy) page, or they can can call the customer service number listed on the back of their BCBSNC ID card for additional information.

If you have a question about your formulary, you may contact your HCW consultant or client manager.

 

EMPLOYEE COMMUNICATION

Below is a simplified message you can use to communicate this change with your employees.

Pharmacy Updates from BCBSNC

Blue Cross and Blue Shield of North Carolina (BCBSNC) recently issued the following pharmacy updates that may apply to you.

Effective June 8, 2018, generic Viagra is available without prior authorization. If you are currently prescribed to take the brand version, you will receive a letter directly from BCBSNC about this change.

Effective May 29, 2018, Colesevelam, a generic version of Welchol, became available. There was no direct communication to members prescribed to brand Welchol from BCBSNC. You should continue receiving the brand medication as you have in the past, but at a reduced price. If you try to receive receive the generic version, Colesevelam, you may be told that your provider needs to submit additional information to BCBSNC. Please contact the BCBSNC customer services number listed on the back of your ID card if you have additional questions or visit the Find a Drug (https://www.bluecrossnc.com/find-a-drug-or-pharmacy) page on the BCBSNC website.