Blue Cross setting new quantity limits for Vyvanse^®, Adderall^® and Adderall XR^®; Vyvanse placed in off-label program

On June 15, 2015, Blue Cross Blue Shield of Michigan will implement new quantity limits for the following drugs:

The quantity limits only affect our commercial (non-Medicare) members who have Blue Cross pharmacy benefits that include quantity limits. They don’t apply to MESSA members.

In addition, we will add Vyvanse to the off-label program, also effective June 15, 2015.

If necessary, you can request an override for the quantity limits or off-label program for your patients. The request will need to include documentation that the amount prescribed is medically necessary.

To obtain a form to request a quantity limit or off-label program override, log in as a provider at bcbsm.com or call the Pharmacy Services Clinical Help Desk at 1-800-437-3803.

Our goal is to provide our members with safe, high-quality prescription drug therapies. Adderall, Adderall XR and Vyvanse are controlled substances that are sometimes misused and abused. But we realize that some patients can benefit greatly from these drugs. The quantity limits align with dosing guidelines approved by the U.S. Food and Drug Administration to prevent unsafe use in our members.

We sent letters in May to notify members who may be affected by these quantity limit changes. The letters encourage members to discuss treatment options with their physicians.

If you have any questions about this program, contact the Pharmacy Services Clinical Help Desk.