New Pharmacy Prior Authorization Going Live on January 1, 2021

  • Pharmacy News
    Published November 16, 2020

    Beginning January 1, 2021, Premera Blue Cross is implementing updates for new and existing prior authorizations. The drugs in the table will require prior authorization.

    Condition Drugs Requiring a New Prior Authorization Preferred Alternatives
    High Cholesterol Praluent®(alirocumab)
    • Repatha® (evolocumab)
    Inflammation Apriso® (mesalamine)
    Asacol® HD (mesalamine)
    • Mesalamine tablets
    • Balsalazide tablet
    Inflammation Colazal®(balsalazide)
    Delzicol® (mesalamine)
    Dipentum® (olsalazine)
    Giazo ™ (balsalazide)
    Lialda ™ (mesalamine)
    Pentasa® (mesalamine)    		  
    Inflammation Cosentyx® (secukinumab)
    • Taltz® (ixekizumab)
    Inflammation Viberzi ® (eluxadoline)
    • Loperamide
    • Dicyclomine
    Rare Disease Sucraid® (sacrosidase)  
    Weight Loss Contrave® (naltrexone-bupropion)
    Qsymia® (phentermine-topiramate)
    Saxenda® (liraglutide)
    Xenical® (orlistat)    		  

    How we are notifying members

    Impacted members will receive a letter in the mail this month, November 2020, notifying them of the change. A preferred alternative drug is available, and we are encouraging members to talk to their doctor to discuss their options and address any questions or concerns they may have.

    If you have any questions about the prior authorization, please contact your Premera representative or producer.

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