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October 2022
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Market Edge
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News for All Segments | All brands
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Updates to the Select and Value formularies for January 1
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Beginning January 1, 2023, updates are being made to traditional and continuous glucose monitoring supplies for commercial plan members utilizing the Value and Select Drug Program formularies.
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Updates to traditional glucose monitoring supplies include the following:
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- OneTouch® products will no longer be the preferred brand test strip/meters on the Select Drug Program and on the Value Formulary.
On the Select Drug Program, OneTouch and all non‑Contour test strips will be non‑preferred and will require prior authorization.
On the Value Formulary, OneTouch and all non‑Contour test strips will be non‑formulary.
- Contour® will be the preferred brand test strip/meters and will not require prior authorization.
- With these updates in preferred test strips, AmeriHealth is offering a free Contour meter. The new meter can be used with the preferred Contour brand test strips.
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Continuous glucose monitoring (CGM) is wearable technology that makes it easier to track your blood sugar levels over time. CGMs are adjunctive devices that allow individuals to track glucose levels and detect episodes of high and low blood sugar in real time on an ongoing basis. The following update is being made to CGM devices:
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- Freestyle Libre® products will no longer be the preferred CGM on the Select Drug Program and on the Value Formulary.
On the Select Drug Program, Freestyle Libre will be non‑preferred and will require prior authorization
On the Value Formulary Freestyle Libre will be non‑formulary.
- Dexcom® products will be the preferred CGM.
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Updates to Value and Select formularies
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AmeriHealth routinely updates our prescription drug formularies and reviews the list of drugs requiring prior authorization as part of our procedures for safe prescribing. These updates are approved by our Pharmacy and Therapeutics Committee.
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Updates are made to the Value and Select formularies quarterly.
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Please view the list of updates to the Value Drug Program Formulary and the Select Formulary for AmeriHealth New Jersey. Current Formulary information for AmeriHealth New Jersey can also be found here.
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You can also view the updates to the Select Formulary for AmeriHealth Administrators plans that require prior authorization and those that do not require prior authorization. Current Formulary information for AmeriHealth Administrators can also be found here under "Prescription Drug Information."
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Standard updates can include:
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- Additions of generic drugs to both formularies
- Additions to the list of drugs that require prior authorization on both formularies
- Deletions to the list of drugs that require prior authorization on both formularies
- Deletions of brand and generic drugs on the Value formulary
- Moving drugs from a lower tier to a higher tier on both formularies
- Moving drugs from a higher tier to a lower tier on both formularies
- Addition of quantity and/or age limits to drugs on both formularies
- Updates to the prior authorization requirements for drugs on both formularies
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Members and their providers who are affected by these updates will receive notification letters this week, 60 days in advance. Members are encouraged to talk to their provider about switching to the preferred products in order to avoid any disruption in their therapies.
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