Prescription Drug Changes Effective July 1, 2017

Prescription Drug Changes Effective July 1, 2017

6/13/2017

Effective July 1, 2017, BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan will implement changes to the pharmacy benefits that will affect our member’s prescription drug coverage and medical benefits. Our pharmacy committee composed of independent doctors and pharmacists continually review and compare prescription drugs to ensure the drugs we cover include proven medications to treat the majority of medical conditions. The decision to exclude or change the benefit coverage of any of the drugs below was made because other safe, effective, less costly alternatives are available. These changes do not apply to groups that use the CVS/caremark drug list. CVS/caremark is a division of CVS Health, an independent company that provides pharmacy services on behalf of BlueCross and BlueChoice®.

  1. Certain prescription and over-the-counter (OTC) drugs in the Proton Pump Inhibitors (PPI) and Non-Sedating Antihistamines (NSAs) drug classes will be excluded under the pharmacy benefit.
 PPI 
 Excluded Drugs (Prescription & OTC) 
 Aciphex  First Omeprazole  Omeprazole (OTC only)  Prilosec
 Dexilant  Lansoprazole  Omeprazole/Sodium Bicarbonate  Protonix
 Esomeprazole  Nexium  Prevacid  Rabeprazole
       Zegerid

Note: We will continue to cover prescription Omeprazole and Pantoprazole (generic versions of Prilosec and Protonix) under the Pharmacy Benefit.

 NSAs 
 Excluded Drugs (Prescription & OTC) 
 Alavert  Clarinex  Claritin-D  Fexofenadine-Pseudoephedrine
 Allegra  Clarinex-D  Desloratadine  Xyzal
 Allegra-D  Claritin  Fexofenadine  Zyrtec
       Zyrtec-D

Note: We will continue to cover all formulations of prescription and OTC Cetirizine and Loratadine (generic versions of Zyrtec and Claritin) – including combinations with Pseudoephedrine – under the Pharmacy Benefit.

  1. The drug Spinaraza will be covered only for members with Type 1 Spinal Muscular Atrophy (SMA) under the member’s medical benefits.
If you have questions about this bulletin, please send an email to provider.education@bcbssc.com or submit your question using the Provider Education Contact Form. As additional information, our members received notices regarding these pharmacy benefit changes.