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