Capital Blue Cross (CBC) Formulary Updates

CBC released information on the recent updates to their formulary for the beginning of 2014.  Formulary updates are communicated via CBC’s BenefitFOCUS, Simply-Well and the Provider Administrative Bulletin. Quarterly Formulary Update Decision Summaries can also be found on the pharmacy page in the member section of the CapBlueCross.com website.  Updates have been made to the following:

  • Generic Watch is a list of generic drugs that are expected to become available in 2014.
  • Newly Marketed Drugs is a list of new to market drugs to be added to the formulary.
  • Products Changing Tier Status is a list of any drugs that have changed coverage tier.
  • Pharmacy Utilization Management Program Updates is a list of drugs that have been added to Prior Authorization, Enhanced Prior Authorization and/or Quantity Level Limit Programs
  • Specialty Drug Watch is a list of specialty drugs that are expected to be reviewed for approval by the Food and Drug Administration in 2014. Specialty drugs are biotech and other self-administered prescription drugs that are typically used in the treatment of complex illnesses.

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The information provided is for informational purposes only and does not constitute legal advice. The information above contains only a summary of the applicable legal provisions and does not purport to cover every aspect of any particular law, regulation or requirement. Depending on the specific facts of any situation, there may be additional or different requirements. This is to be used only as a guide and not as a definitive description of your compliance obligations.