RxNews

Newly available generic alendronate (Fosamax®) is an excellent opportunity to reduce patients’ copayments for bisphosphonates. Alendronate has the proven ability to reduce fractures, is an excellent value to treat osteoporosis, and is available as a generic daily or weekly treatment option. More costly brand name bisphosphonates, including Actonel®, Boniva®, and Reclast® provide no additional clinical benefit and will need prior authorization before they can be covered for Regence members.

Beginning August 1, 2008, prior authorization will be needed for coverage of brand-name osteoporosis medications Actonel and Boniva when dispensed from a pharmacy.  Prior authorization will be needed for Reclast and Boniva IV starting December 1, 2008.

Regence’s coverage policy was developed to encourage generic alendronate. Our coverage policies for Actonel, Boniva, and Reclast will be available on the Internet at: blue.regence.com/policy/medication/index.html. Our prior authorization request form is available on the internet at: www.regencerx.com/docs/forms/priorAuth/priorAuthorization.pdf.

Prior authorization will be needed only for new prescriptions. However, because of the significant cost saving potential of generic alendronate, we encourage you to consider it even for patients who are currently using Actonel or Boniva.

Our implementation schedule is as follows:

Please note: The medication policies and pharmacy claims system will not impact members who are currently taking Actonel, Boniva, Boniva IV and Reclast.  Members will continue to receive coverage for medication they are currently using and  prior authorization will not be needed.

If you have any questions, please contact Pharmacy Customer Service at 1 (800) 643-5918