Recently, important system functionality required that claims for drugs dispensed in their smallest available marketed package size (unbreakable packages) must be submitted with the correct days’ supply for the submitted quantity.

Medications in “Unbreakable Packages” are those that must be dispensed in their original container/package and cannot be opened or broken. Please submit these claims with a day supply that is consistent with the dosing instructions on the prescription, even if the day supply exceeds the pharmacy contract.

*Please see attached PDF for more information.

RXBIN: 004336

RXPCN: MEDDADV

RXGRP: RXCVSD

The generic for Xopenex HFA Inhalation Aerosol recently became available in the marketplace; however, effective October 21, 2016, SilverScript will continue to cover the brand name Xopenex HFA at the Preferred Brand Tier.

The generic (levalbuterol tartrate HFA inhalation aerosol) will NOT be covered for SilverScript plan members. Please continue to dispense Xopenex HFA as prescribed rather than substituting the generic. If claims for the generic are submitted, the following reject will occur:

Reject 70 <<Dispense Brand – Xopenex HFA>>

If you need assistance, call the Pharmacy Help Desk at 1-866-693-4620.

Note: This does not apply to SilverScript Employer PDP plans.

Inside this issue of Express Scripts Network Pharmacy Weekly, you will find the following:

• Express Formulary Changes
• Anthem Refills Allowed Limits
• Anthem Pharmacy Home Program

*Please see attached PDF for more information.