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Prime Therapeutics Specialty Pharmacy Drug Management List Reminder About Coverage for Self-Administered Specialty Medications
Specialty medications are generally prescribed to treat chronic, complex medical conditions, such as multiple sclerosis, hepatitis C and
rheumatoid arthritis. These medications are often received by injection or infusion, require careful adherence to a treatment plan and/or
have special handling or storage requirements. Specialty medications that require professional services for administration are usually
covered under the medical benefit. Coverage for self-administered specialty medications is provided through the pharmacy benefit. The
physician should write or call in a prescription for self-administered specialty medications for receipt from a specialty pharmacy provider.
Below is a current list of specialty medications. Medications with an (M) placed after their names may be eligible for coverage under the
medical benefit. The rest of the medications are FDA-approved for self-administration and are covered under the pharmacy benefit in most
circumstances.
Autoimmune
Degeneration
Hormones
Fibrosis
CIMZIA PREFILLED SYRINGE NEXAVAR
KALYDECO
INCRELEX*
Multiple
PULMOZYME
Sclerosis
REVLIMID*
OMNITROPE
BETASERON
Deficiencies
COPAXONE
(Continued on Page 2)
Hepatitis C
THALOMID
tretinoin
Modifiers
VOTRIENT*
INTRON-A
XALKORI*
NEULASTA
ZELBORAF*
NEUPOGEN
ORFADIN*
ribavirin
VICTRELIS
Clotting
Disorders (M) ♦♦♦
Cancer –
Injectable
Fertility &
SYLATRON
Pregnancy
Drugs in BOLD are preferred
Disorders
products
Cancer –
FOLLISTIM AQ
AFINITOR
This list is subject to change without notice.
Prime Therapeutics LLC is the independent company chosen by the Blue Cross and Blue Shield of Oklahoma to manage your prescription drug benefit. Blue Cross and Blue Shield of Oklahoma is a Division of Health Care Service Corporation, A Mutual Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. 4220 OK Prime Therapeutics LLC 5/1/13 Prime Therapeutics Specialty Pharmacy LLC is a wholly owned subsidiary of Prime Therapeutics LLC. Product names are the property of their respec Prime Therapeutics Specialty Pharmacy Drug Management List
Multiple
Sclerosis (continued)
GILENYA

Pulmonary
Hypertension
ADCIRCA
epoprostenol sodium*
(M)
FLOLAN* (M)
TRACLEER*
CHENODAL*
administration: IA, IL, IM, IO, IT, ITV & IV. Check your leuprolide acetate
Drugs in BOLD are preferred
products
octreotide acetate
Brand-name products are capitalized (e.g. FLOLAN) This list is subject to change without notice.
Prime Therapeutics LLC is the independent company chosen by the Blue Cross and Blue Shield of Oklahoma to manage your prescription drug benefit. Blue Cross and Blue Shield of Oklahoma is a Division of Health Care Service Corporation, A Mutual Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. 4220 OK Prime Therapeutics LLC 5/1/13 Prime Therapeutics Specialty Pharmacy LLC is a wholly owned subsidiary of Prime Therapeutics LLC. Product names are the property of their respective owners.

Source: http://www.bcbsok.net/forms/specialty_drug_list.pdf

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