December 21, 2017
Starting January 1, 2018, all prescriptions for Revatio and its generic (sildenafil 20mg) must have prior authorization from us to be covered by our metallic (state health exchange) plans' pharmacy benefit.
Prior authorization ensures the drug is being used for its FDA-approved purpose. This drug is FDA-approved for the treatment of certain types of pulmonary arterial hypertension (PAH) to:
- Improve your ability to exercise
- Slow advancement of symptoms
Learn more about how to submit requests for pharmacy prior authorization, including options for electronic prior authorization.
With cold and flu season upon us, it's a good time to talk about the overuse of antibiotics. As part of a an international effort to optimize patient outcomes, improve population health, save money, and preserve the effectiveness of these lifesaving medications, a suite of tools and resources was created to improve use of antibiotics. Consider sharing these resources with providers and facilities in your organization.
The Antimicrobial Stewardship Toolkit for Ambulatory Settings is now available. The toolkit includes
Why is this important?
The Blue Cross Blue Shield Association (BCBSA) recently conducted a study on claims data focusing on the overuse of antibiotics for non-bacterial illnesses. While the BCBSA claims data showed there's been a general decline in prescriptions filled for children and adults (16 percent for kids and 13 percent for adults), there is still work to do.
In 21 percent of cases, patients were prescribed antibiotics for conditions where these medications wouldn't be effective. In 75 percent of these questionable cases, broad spectrum antibiotics were prescribed. These medications cover a wide range of bacteria and are most likely to trigger the development of antibiotic-resistant strains of bacteria. There was also a 30 percent increase in the prescribing of reserved antibiotics, typically used for antibiotic-resistant bacteria like MRSA.
What can you do?
Have a conversation with your patients about the overuse of antibiotics. The Choosing Wisely site, a patient-friendly resource developed by Consumer Reports in conjunction with medical specialties, offers many resources on the best use of antibiotics. It includes information on how to talk to your doctor, ways to relieve symptoms, and symptoms that may require the use of antibiotics. We encourage you to share these great resources with patients, friends, and family to help everyone stay healthy.