Topical Retinoid Program Revised, New Drugs Added to Current Programs
Blue Cross Blue Shield of North Carolina (BCBSNC) made the following changes to their pharmacy program.
- Topical Retonoid Prior Plan Approval Program (Providers were notified of these changes on May 9.)
- Adapalene products (Adapalene e.g. Differin; Adapalene/benzoyl peroxide e.g. Epiduo) – the age restriction was removed. Members will continue to be required to try a generic before they can use one of these brand drugs.
- Tazarotene (Tazorac) – the age restriction was changed from age 25 to 35. Patients aged 35 and younger who have recent claims history of obtaining a generic tretinoin product will not require review.
- Tretinoin products (Tretinoin e.g. Retin-A, Tretin-X, Avita, Atralin; Tretinoin microsphere e.g. Retin-A Micro/Pump; Tretinoin/clindamycin phosphate gel e.g. Veltin, Ziana; Tretinoin bulk powder) – the age restriction was changed from age 25 to 35. Patients aged 35 and younger with a current prescription for generic topical tretinoin or who have recent (within the past 365 days) claims history of obtaining a generic tretinoin product will not require review.
- Subsys is a new drug that was added to the transmucosal fentanyl program. It is a fentanyl drug in a spray form.
- Qnasl is a new drug that was added to the restricted access list of intranasal steroids.
- Provigil: this drug now has a generic, and both the brand AND generic will require prior plan approval.
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