BlueChoice HealthPlan constantly evaluates our prescription drug formularies and drug management programs to ensure that quality and costs are managed effectively. We work with a group of independent doctors and pharmacists to evaluate our pharmacy programs and get recommendations.
Based on their feedback, BlueChoice
® will make minimal changes to the
formularies, Prior Authorization and Quantity Management programs.
All changes go into effect Oct. 1, unless noted otherwise.
Drug Exclusions
After careful evaluation, we have determined to exclude
select drugs produced by certain manufacturers from our formulary. These manufacturers have adopted a business model to buy the rights to certain older drugs and then raise the cost of those products. For some drugs, they increased the prices ranging from 500 percent to more than 7,000 percent!
These practices have come under scrutiny by the federal government because of questionable pricing practices and exponential rate increases. Many times, these drugs have no better efficacy or safety profiles than more cost-effective, therapies available on our formulary. In some cases, these extraordinarily high priced drugs are less effective than other formulary treatments.
All excluded drugs have comparable alternatives on our formulary.
Questions
If you have questions, please contact your BlueChoice representative.
