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September 2018

We’re adding Pulmozyme to the drug prior authorization program, beginning Oct. 1

Effective Oct. 1, 2018, Blue Cross Blue Shield of Michigan and Blue Care Network will add Pulmozyme (dornase alfa) to the pharmacy benefit drug prior authorization program for commercial PPO and HMO members.

Pulmozyme is used to improve lung function in people with cystic fibrosis, in conjunction with standard therapies.

Members should have their prescribers submit a request for authorization from us before payment is approved for this medication.

Members who have an existing prior authorization for any of the following drugs are not required to get a prior authorization for Pulmozyme:

  • Orkambi®
  • Symdeko®
  • Kalydeco®

If we don’t authorize this drug in advance, it may cost more or we may not cover it at all.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2017 American Medical Association. All rights reserved.
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