Controlling healthcare costs and improving the lives of those affected by diabetes is a top priority for Independence Blue Cross (IBC). Therefore, IBC has selected two preferred insulin drugs, which will aid in controlling your costs while still providing members with access to effective medications.

WHAT THIS MEANS TO YOU AS AN EMPLOYER?
These changes will affect Independence Blue Cross members under the IBC prescription drug program administered by FutureScripts. In order to help you understand how these changes affect members and the options that are available to them, please see the important information below which includes the latest updates to the Select Drug Program formulary.

Preferred Brand Of Insulin
Effective April 1, 2010, Novolin® and Novolog® will be the preferred insulin drugs for IBC prescription drug programs and Humulin®, Humalog®, ReliOn®/Novolin®, and Apidra® insulin will now be considered non-preferred for all programs. For Select Drug Program members, Novolin and Novolog will be the only insulin covered at the brand-formulary level, while Humulin, Humalog, and ReliOn/Novolin insulin will be removed from the Select Drug Program formulary. The FutureScripts Pharmacy and Therapeutics Committee, whose members include practicing physicians and pharmacists from the area, have determined that Novolin and Novolog are clinically equal to Humulin, Humalog, ReliOn/Novolin, and Apidra insulin in lowering blood sugar levels, which is a key clinical marker in diabetes management.

New Prior Authorization Requirement
Also, effective April 1, 2010, all newly prescribed non-preferred insulin will require prior authorization. Members who are currently taking non-preferred insulin do not have to obtain prior authorization until July 1, 2010. Prior authorization requests will be reviewed in accordance with IBC’s established criteria, and, if approved, non-preferred insulin will be covered at the appropriate cost-sharing level. If denied, non-preferred insulin will not be a covered benefit.

What Members Should Do
Since it is essential for members to maintain their insulin therapy to help prevent many diabetes-related health problems, IBC is encouraging members who take Humulin, Humalog, ReliOn/Novolin, or Apidra to talk with their doctor to discuss which insulin is right for them. If a member’s doctor writes a prescription for Novolin and/or Novolog, the member will pay the appropriate copayment at participating retail pharmacies and through the mail order program, if applicable. If a member’s doctor recommends that the member continue using his or her current non-preferred insulin, he or she will be able to obtain this medication until June 30, 2010. After June 30, the member’s doctor will need to complete a prior authorization form and receive approval from IBC for the member to continue to receive coverage for that brand of insulin medication.

Select Drug Program Formulary Changes
IBC is also making changes to the Select Drug Program formulary and their guidelines concerning procedures that support safe prescribing of prescription drugs. These changes will take effect on April 1, 2010.

CLICK HERE to view a list for formulary updates.

CLICK HERE to view the formulary guide.

Communicating Information to Members
Affected members will be notified of these changes. Select Drug Program members who are affected by the insulin and/or other formulary changes will be notified of the changes this month. All members, regardless of their drug coverage, taking a non-preferred brand of insulin through March 31 will receive a letter notifying them of the prior authorization requirement in May. These changes will also appear in the spring edition of Update magazine as well as online, where the updated formulary guide will also be posted.

Employer groups who have members directly affected by the insulin changes will receive a letter from IBC explaining the changes, why they are making them, and what the employer should do next.

WHAT SHOULD I DO NEXT?
Please communicate this important information to your enrolled employees.

If you have any additional questions regarding the information within this eCommunication, please call Corporate Synergies at 1.866.CSG.1719 or CLICK HERE to contact us today.

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