As part of our ongoing efforts to manage these drug costs, we are expanding our precertification program to include medical specialty edits. The expansion of our precertification program will allow clients who currently have our precertification program to benefit from these enhancements. There are two components to this expansion:
Sharp Health Plan Transitioning From Diplomat to CVS Specialty Pharmacy
Effective February 25, 2017, Sharp Health Plan is moving from Diplomat to CVS Specialty Pharmacy. According to Sharp, they found that CVS provides greater flexibility on how members can fulfill their specialty medication needs.
Specialty Drug Management Changes for Anthem Blue Cross Health Plans
Health care costs continue to rise, and specialty drugs are a big contributor. These prescription medicines are used to treat complicated and chronic conditions, such as hepatitis C, cancer and multiple sclerosis. As specialty drugs become more widely used, we’re looking for new ways to control costs while keeping members healthy. That’s why we created our Right Drug Right Channel (RDRC) program.