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November 2016

Certain high-cost products to treat skin conditions won’t be covered due to comparable alternatives

As you read in the September Record, Blue Cross Blue Shield of Michigan commercial plans don’t cover select high-cost, FDA-approved drugs for which more cost-effective therapeutic alternatives are available. This is part of an ongoing effort to address the high cost of drugs and provide the best possible value for our members.

Ultravate®-X kits, Ultravate® lotion, Cordran® lotion, flurandrenolide lotion and Locoid® lotion, which are topical products used to treat corticosteroid-responsive skin conditions, have been targeted for exclusion, effective Oct. 7, 2016. Members currently using these drugs can continue to fill prescriptions for them through Dec. 31, 2016.

The following table includes the approximate cost of the targeted drugs and the associated therapeutic alternatives:

Drug names not covered and their costs**

Covered therapeutic alternatives and their costs**

Locoid® lotion (hydrocortisone butyrate)

$1,046

Cordran® lotion (flurandrenolide)

$1,101

flurandrenolide lotion

$990

betamethasone dipropionate lotion (Diprosone®)

$47

betamethasone valerate lotion (Valisone®)

$72

triamcinolone lotion (Aristocort, Kenalog®)

$90

Ultravate® lotion (halobetasol propionate)

$1,083

Ultravate®-X cream kit
(halobetasol + lac-hydrin, OTC)

$1,083

Ultravate®-X ointment kit
(halobetasol + lac-hydrin, OTC)

$1,083

augmented betamethasone
dipropionate- cream, ointment, lotion (Diprolene®)

$75 - $186

clobetasol propionate- cream, ointment (Temovate®)

$459 - $520

fluocinonide- cream, ointment (Lidex®,
Lidex-E®)

$182 - $293

halobetasol propionate- cream,
ointment (Ultravate®)

$191

**Approximate cost for a 30-day supply based on the average wholesale price.

In some cases, members’ out-of-pocket costs for these brand-name drugs may be lower than their copay due to manufacturer savings cards. However, the high cost of these drugs will be reflected in future premium rates and the overall claims experience for members and plans.

As part of this ongoing initiative, Blue Cross will continue to identify select high-cost drugs and will stop covering them when there are more cost-effective alternatives available for our commercial members.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2015 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.