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January 2017

Tier changes for some hepatitis C drugs start Jan. 1

Blue Cross Blue Shield of Michigan and Blue Care Network are changing how they manage certain hepatitis C drugs starting Jan. 1, 2017.

Zepatier™ and Epclusa® will:

  • Move to a preferred tier on drug lists.
  • Have a lower copayment than drugs on the nonpreferred tier.
  • Require approval prior to coverage.

Zepatier will be the preferred drug for patients with hepatitis C, genotype 1 and 4, viral infections. And Epclusa will be the preferred drug for patients with hepatitis C viral infections when Zepatier isn't indicated.

Sovaldi®, Harvoni® and Viekira Pak™ will:

  • Move to a nonpreferred tier on drug lists.
  • Require member use of a preferred drug before nonpreferred drug approval.
  • Require approval prior to coverage.

Patients currently taking Sovaldi, Harvoni and Viekira Pak will be allowed to continue treatment and pay their current copay.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2016 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
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