Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and IN PathWays for AgingSeptember 28, 2018
Updated Formulary: Asthma controller medication
Effective August 1, 2018, Anthem updated the formulary for asthma controller medications. The table below provides details regarding the new requirements for members:
Inhaled corticosteroid (ICS) products
|
|
May prescribe without Prior Authorization |
|
Medication |
Formulary status |
Under age 12 |
Age 12 and older |
Arnuity® Ellipta® |
Preferred |
|
X |
Budesonide Respules |
Preferred |
X (age 0-5) |
|
Alvesco® | Nonpreferred | ||
Asmanex HFA | Nonpreferred | ||
Asmanex Twisthaler® | Nonpreferred |
X (age 0-5) |
|
Flovent® Diskus® | Preferred | X | X |
Flovent® HFA | Preferred | X | X |
Pulmicort Flexhaler® | Nonpreferred | ||
Pulmicort Respules® | Nonpreferred | ||
Qvar Redihaler | Nonpreferred | ||
Qvar HFA | Preferred only under age 12 |
X (age 0-11) |
ICS/long-acting beta agonists products
|
|
May prescribe without Prior Authorization |
|
Medication |
Formulary status |
Under age 12 |
Age 12 and older |
Breo® Ellipta® |
Preferred |
|
X |
fluticasone-salmeterol (generic for AirDuo RespiClick®) |
Preferred |
|
X |
Advair Diskus® |
Nonpreferred |
X (age 4-11) |
|
Advair® HFA |
Nonpreferred |
|
|
Dulera® |
Nonpreferred |
|
|
Symbicort® |
Nonpreferred |
|
|
Preferred spacers for inhalers
New name |
Type |
Status |
Available mask |
Antistatic |
Latex free |
Breatherite™ |
VHC |
Preferred |
Yes |
Yes |
Yes |
LiteAire® |
Spacer |
Preferred |
N/A |
|
|
Microspacer/Chamber |
Spacer |
Preferred |
N/A |
|
|
OptiChamber |
VHC |
Preferred |
Yes |
Yes |
Yes |
Pocket Spacer |
Spacer |
Preferred |
N/A |
|
|
Vortex® |
VHC |
Preferred |
Yes |
Yes |
|
Prescribing preferred products helps prevent the need for PA as well as eliminates the inconvenience of denied medications for your patients.
If you determine preferred products are not clinically appropriate for a specific patient, you can do one of the following to obtain PA:
- Call our Pharmacy department and follow the voice prompts for pharmacy PA at:
- 1-866-408-6132 for Hoosier Healthwise
- 1‑844‑533‑1995 for Healthy Indiana Plan
- 1-844-284-1798 for Hoosier Care Connect
- Fax the Pharmacy PA Form (www.anthem.com/inmedicaiddoc / Provider Support / Forms / Pharmacy) and all required information to 1-844-864-7860
- Submit a request using the electronic PA process at https://covermymeds.com
PUBLICATIONS: October 2018 Anthem Indiana Provider Newsletter
To view this article online:
Visit https://providernews.anthem.com/indiana/articles/updated-formulary-asthma-controller-medication-535
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