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September 2014
We have new quantity limits for 2 opioid medications
On Sept. 2, 2014, Blue Cross Blue Shield of Michigan will implement new quantity limits for the following drugs:
Generic |
Brand name |
New quantity covered |
Oxycodone immediate release (IR) tablet and capsule |
Roxicodone®
OxyIR® |
180 per 30 days |
Oxymorphone immediate release tablet |
Opana® |
180 per 30 days |
The new limits apply to all strengths of the generic and brand-name versions of these drugs. This change will only affect BCBSM commercial (non-Medicare) members who have BCBSM pharmacy benefits that include quantity limits. It doesn’t apply to MESSA members.
As always, our goal is to provide our members with safe, high-quality prescription drug therapies. We realize that some patients can benefit greatly from the effective pain relief offered by these drugs. However, unsupervised use, misuse or abuse of prescription painkillers can lead to addiction, hospitalization and even death.
We began sending letters to notify members who may be affected by these quantity limit changes in August. The letters encourage them to discuss treatment options with their physicians.
If necessary, you can request an override for the quantity limits for your patients. The request will need to include documentation that the amount prescribed is medically necessary.
To obtain the form that requests a quantity limit override, log in as a provider at bcbsm.com or call the Pharmacy Services Clinical Help Desk at 1-800-437-3803.
If you have any questions about this program, contact the Pharmacy Services Clinical Help Desk. | 