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March 2018
6 drugs added to commercial PPO 15-Day Specialty Drug Limitation Program
To match Blue Care Network’s HMO program, Blue Cross Blue Shield of Michigan’s commercial PPOs are adding six medications to its 15-Day Specialty Drug Limitation Program.
Blue Cross commercial PPO
15-Day Specialty Drug Limitation Program
New drugs as of April 1, 2018 |
Cabometyx® |
Gleevec®
Imatinib (generic) |
Lenvima® |
Cometriq® |
Imbruvicia® |
Zelboraf® |
Starting April 1, 2018, instead of a 30-day supply, we’ll limit all fills of these drugs to a 15-day supply per fill. This includes first fills and refills. Members pay half of their copayment for a 15-day supply.
Blue Cross limits the day-supply quantity of a medication that a pharmacy can dispense to:
- Help save members money on copayments
- Reduce drug waste
We’ll add more drugs to the 15-day program throughout the year. The full list, including the six new drugs, follows:
Blue Cross commercial PPO
15-Day Specialty Drug Limitation Program
Full drug list as of April 1, 2018 |
Afinitor® |
Nerlynx® |
Afinitor Disperz |
Nexavar® |
Cabometyx® |
Tarceva® |
Calquence® |
Verzenio™ |
Cometriq® |
Votrient™ |
Gleevec®
Imatinib (generic) |
Zejula™ |
Imbruvicia® |
Zytiga™ |
Lenvima® |
Zelboraf® |
There’s no change to the BCN commercial HMO 15-Day Specialty Drug Limitation Program. Its full drug list for 2018 follows:
BCN commercial HMO
15-Day Specialty Drug Limitation Program
2018 drug list |
Afinitor® |
Afinitor Disperz® |
Bosulif® |
Cabometyx™ |
Calquence® |
Caprelsa® |
Cometriq® |
Erivedge® |
Exjade® |
Gilotrif™ |
Gleevec® |
Iclusig™ |
Imbruvica™ |
Inlyta® |
Jadenu™ |
Jakafi® |
Lenvima™ |
Lynparza™ |
Nerlynx® |
Nexavar® |
Odomzo® |
Sprycel® |
Sutent® |
Tagrisso™ |
Tarceva® |
Targretin® |
Tasigna® |
Verzenio™ |
Votrient® |
Xalkori® |
Xtandi® |
Zejula™ |
Zelboraf® |
Zolinza® |
Zydelig® |
Zykadia™ |
Zytiga® |
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The 15-Day Specialty Drug Limitation Program doesn’t apply to Medicare, Medicare Advantage or Federal Employee Program® members. | 
