Report a compliance concern or suspected fraud, waste or abuse anonymously, by contacting Primes24-hour anonymous compliance hotline: 800.474.8651 Prescription drugs not covered by BCBSND. Visit Prime Therapeutics to: Search for prescription drugs. In November 2019, Talicia was approved by the U.S. FDA for the treatment of H. pylori infection in adults. Diabetes). Talicia is not recommended for use in pregnancy. RedHill promotes the gastrointestinal drugs Movantik for opioid-induced constipation in adults11, Talicia for the treatment of Helicobacter pylori (H. pylori) infection in adults and Aemcolo for the treatment of travelers diarrhea in adults12. This consent will be in effect for one year from the date it is granted. A prescription medication or drug with an excluded pharmacy benefit route of administration will reject at pharmacy point of sale and may be covered under the medical benefit. Non-formulary drugs . Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software. Talicia is contraindicated in patients receiving delavirdine or voriconazole. All rights reserved. Please click the "refresh" button in your browser/window, or try again soon. Coverage of prescription drugs and supplies listed on the drug list/formulary is subject to your benefit plan's design and coverage provisions, and may differ from that listed. Routes of Administration Pharmacy Benefit Exclusion ListRoutes of Administration Self-Administered Drug List, 2023 NetResults HSA Preventive Drug List2023 NetResults Value Based Design (VBD) Drug List2023 NetResults FormularyNetResults Restricted Use List - OpioidsNetResults Quantity Limit Program Summary, Fargo (Headquarters) Prime Therapeutics is responsible for: Processing and paying Rx claims; Developing and maintaining the drug formulary To submit a prior approval authorization request: See the guidelines for prior approval or have restricted-use drugs: Restricted-Use Prior Approval DrugsRestricted-Use OpioidsRestricted-Use Step Therapy DrugsRestricted-Use InsulinRestricted-Use Drug Dispensing Limits (BCBSND Formulary)Restricted-Use Drug Dispensing Limits (Qualified Health Plans). Or, register your account in 3 easy steps. However, the content providers do not warrant the accuracy of the information in the website, nor of codes, prices or other data available on this website. Medicare Prescription Drug Coverage and Your Rights Standardized Phcy Notice Instructions, Medicare Prescription Drug Coverage and Your Rights form, Medicare Prescription Drug Coverage and Your Rights form (Spanish), Minimum Performance and Service Criteria for Medicare Part D, Minimum Performance and Service Criteria for LTC. That way, you won't have to enter it yourself. Approved as a pharmacy medicine, Sanofi will launch Cialis Together in the second half of the year. Please call the number on the members ID card for further assistance or clarification on your patients benefits, including the appropriate prescription drug list. Magazine: Drug Formulary - Prime Therapeutics. NetResults A-Series Prescription Drug Guide, NetResults F-Series Prescription Drug Guide, April 2023 BCBSAL Prescription Drug Guide Updates, April 2023 BCBSAL Generics Plus Drug Guide Updates, April 2023 BCBSIL Multi Tier Enhanced Annual Drug List Updates, April 2023 BCBSIL Multi Tier Basic Annual Drug List Updates, April 2023 BCBSIL Enhanced Annual Drug List Updates, April 2023 BCBSIL Basic Annual Drug List Updates, April 2023 BCBSMN GenRx Formulary Updates, April 2023 BCBSMN FlexRx Formulary Updates, April 2023 BCBSNC 5 Tier Enhanced Formulary Updates, April 2023 BCBSNC 5 Tier Essential Formulary Updates, April 2023 BCBSNC 4 Tier Formulary Updates, April 2023 BCBSTX Basic Annual Drug List Updates, April 2023 BCBSTX Multi Tier Enhanced Annual Drug List Updates, April 2023 BCBSTX Multi Tier Basic Annual Drug List Updates, April 2023 BCBSTX Enhanced Annual Drug List Updates, April 2023 BCBSWY Preferred Drug List Updates, April 2023 Florida Blue Medication Guide Updates, April 2023 Florida Blue Closed Formulary Medication Guide Updates, April 2023 HCSC Enhanced Drug List Updates, April 2023 HCSC Multi Tier Basic Drug List Updates, April 2023 HCSC Multi Tier Enhanced Drug List Updates, April 2023 Horizon BCBSNJ (Public Sector and Labor) Formulary Updates, April 2023 Horizon BCBSNJ Formulary Updates, 2023 Prime Therapeutics LLC | Magellan Rx Management, LLC, a Prime Therapeutics LLC company. These strategies include: All strategies and services are necessary to improve the value of our drug benefits, monitor drug safety and ultimately improve the health outcomes of our members. Talicia is contraindicated in patients receiving rilpivirine-containing products. Talicia is a novel, fixed-dose, all-in-one oral capsule combination of two antibiotics (amoxicillin and rifabutin) and a proton pump inhibitor (PPI) (omeprazole). Regular news and updates on current pharmacy topics. Drug cost estimates are based on current drug pricing. We are excited to strengthen our market access for Talicia, the first and only FDA-approved rifabutin-based therapy for the treatment of H. pylori infection, with the addition to Prime Therapeutics NetResults A-Series National Formulary, as an unrestricted, preferred brand, said Rick Scruggs, RedHills Chief Commercial Officer. FEPreportfraud@PrimeTherapeutics.com. reports@lighthouse-services.com Non-prescription drugs covered by BCBSND when dispensed by a pharmacist upon receipt of a prescription order. One option is Adobe Reader which has a built-in reader. Revoking consent will remove this member's ability to view and manage {patientFirstName}'s prescription information on MyPrime, and will be effective immediately. More information about the Company is available at www.redhillbio.com. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. 2023 Drug Formulary ListLatest Additions and Deletions2023 Health Insurance Market Individual, Small Group Formulary2023 BlueValue Formulary2022 BlueCare, BlueDirect, BlueEssential, BluePartner, BluePrime and SimplyBlue Formulary. on this computer. Effective up to 36 hours. Please contact member services at 1.877.794.3574 for assistance. Policies and procedures: Maintain internal training protocols. Check this box to save your username Ongoing communications about plan changes and additions. External link You are leaving this website/app (site). A therapeutic alternative is a chemically similar drug which can resolve some of the same symptoms. It can also save you money. Go back and select "Option A" to start your account setup with RxSS Pharmacy. For full prescribing information see: www.Talicia.com.2 Defined as the PK population which included those subjects in the ITT population who had demonstrated presence of any component of investigational drug at visit 3 (approx. If your pharmacy needs access to the reporting requirements or you have questions about contractual reporting requirements - please contact the Specialty Network Contracting team at: specialtycontracting@primetherapeutics.com, North Dakota Medicaid D.0 Pharmacy Payer Sheet, BCBS of Illinois Blue Cross Community ICP and FHP (Medicaid) D.0 Payer Sheet, BCBS of Texas Chip, STAR and Star Kids Programs (Medicaid) D.0 Payer Sheet, Medicare Part D Supplemental D.0 Pharmacy Payer Sheet, Minnesota Medicaid D.0 Pharmacy Payer Sheet, Capital Blue Cross Keystone - Capital Cares 4 Kids, Alignment Health Plan Medicare HMO and DSNP, BCBSIL - Blue Medicare Advocate Health (HMO), BlueCross BlueShield of Kansas Preferred Blue Medicare Advantage, Blue Cross & Blue Shield of Nebraska Medicare Part D, Blue Cross & Blue Shield of Rhode Island Healthmate for Medicare, BlueCross BlueShield of Texas Medicare Advantage, Capital Blue Cross Medicare Part D, B and PDP, BlueCross BlueShield of New Mexico Medicare Advantage Dual Care, Regence BlueCross BlueShield of Oregon Align HMO NoRX, Regence BlueShield of Idaho SLHP Align NoRX, Vibra Health Plan Employer Group - Essential PPO. It is contraindicated in patients with known hypersensitivity to any of these medications, any other components of the formulation, any other beta-lactams or any other rifamycin. This consent will be in effect for one year from the date it is granted. Medicaid Alignment Initiative 888.840.3068, Blue Cross and Blue Shield of Minnesota > Secure Blue, Platinum Blue 800.648.2778, Horizon Blue Cross Blue Shield of New Jersey 800.391.1926, BlueCross BlueShield of North Carolina 877.277.7893, BlueCross BlueShield of South Carolina 800.545.8512, Medicaid, Illinois > Family Health Plan 855.457.0173, Medicaid, Illinois > Integrated Care Program 888.274.5218, Medicaid TX STAR Kids Travis 855.457.0757, Medicaid TX STAR Kids/MRSA Central (Medicaid Rural Service Area) 855.457.0758, BlueCross BlueShield of Rhode Island 855.457.1207, NetResults A-Series Prescription Drug Guide, NetResults F-Series Prescription Drug Guide, July 2021 BCBSAL Prescription Drug Guide Updates, July 2021 BCBSAL Generics Plus Drug Guide Updates, July 2021 BCBSMN FlexRx Formulary Updates, July 2021 BCBSWY Preferred Drug List Updates, July 2021 IL Basic Annual Drug List Updates, July 2021 IL Enhanced Annual Drug List Updates, July 2021 TX Enhanced Annual Drug List Updates, July 2021 IL Multi Tier Enhanced Annual Drug List Updates, July 2021 TX Multi Tier Enhanced Annual Drug List Updates, July 2021 IL Multi Tier Basic Annual Drug List Updates, July 2021 TX Multi Tier Basic Annual Drug List Updates, July 2021 BCBSTX Basic Annual Drug List Updates, July 2021 HCSC Enhanced Drug List Updates, July 2021 HCSC Multi Tier Enhanced Drug List Updates, July 2021 HCSC Multi Tier Basic Drug List Updates, July 2021 Florida Blue Closed Formulary Medication Guide Updates, July 2021 Florida Blue Medication Guide Updates, July 2021 BCBSNC 4 Tier Formulary Updates, July 2021 BCBSNC 5 Tier Formulary Updates, July 2021 Horizon BCBSNJ Formulary Updates, October 2021 Medicare Part D Negative Formulary Change(s) Notification, September 2021 Medicare Part D Negative Formulary Change(s) Notification, August 2021 Medicare Part D Negative Formulary Change(s) Notification, July 2021 Medicare Part D Negative Formulary Change(s) Notification, June 2021 Medicare Part D Negative Formulary Change(s) Notification, May 2021 Medicare Part D Negative Formulary Change(s) Notification, April 2021 Medicare Part D Negative Formulary Change(s) Notification, March 2021 Medicare Part D Negative Formulary Change(s) Notification, February 2021 Medicare Part D Negative Formulary Change(s) Notification, January 2021 Medicare Part D Negative Formulary Change(s) Notification, December 2020 Medicare Part D Negative Formulary Change(s) Notification, November 2020 Medicare Part D Negative Formulary Change(s) Notification, October 2020 Medicare Part D Negative Formulary Change(s) Notification, September 2020 Medicare Part D Negative Formulary Change(s) Notification, August 2020 Medicare Part D Negative Formulary Change(s) Notification, July 2020 Medicare Part D Negative Formulary Change(s) Notification, June 2020 Medicare Part D Negative Formulary Change(s) Notification, May 2020 Medicare Part D Negative Formulary Change(s) Notification, April 2020 Medicare Part D Negative Formulary Change(s) Notification, March 2020 Medicare Part D Negative Formulary Change(s) Notification, February 2020 Medicare Part D Negative Formulary Change(s) Notification, January 2020 Medicare Part D Negative Formulary Change(s) Notification, December 2019 Medicare Part D Negative Formulary Change(s) Notification, November 2019 Medicare Part D Negative Formulary Change(s) Notification, October 2019 Medicare Part D Negative Formulary Change(s) Notification, September 2019 Medicare Part D Negative Formulary Change(s) Notification, August 2019 Medicare Part D Negative Formulary Change(s) Notification, July 2019 Medicare Part D Negative Formulary Change(s) Notification, June 2019 Medicare Part D Negative Formulary Change(s) Notification, May 2019 Medicare Part D Negative Formulary Change(s) Notification, October 2017 Florida Blue Utilization Management Update, January 2017 Florida Blue Utilization Management Update, April 2016 Florida Blue Utilization Management Update, January 2016 Florida Blue Utilization Management Update. Further, in an analysis of data from this study, it was observed that subjects who were confirmed adherent2 to their therapy had response rates of 90.3% in the Talicia arm vs. 64.7% in the active comparator arm3. The retail prices displayed above represent estimated prices for your prescription drugs at a common retail pharmacy. Prime Therapeutics LLC is a pharmacy benefit management company. Talicia is eligible for a total of eight years of U.S. market exclusivity under its Qualified Infectious Disease Product (QIDP) designation and is also covered by U.S. patents which extend patent protection until 2034 with additional patents and applications pending and granted in various territories worldwide. Specialty, compounding, mail order and single ingredient thresholds may be changed by Prime in its sole discretion at any time. We can send your basic member information for you. Age and gender are not factored into pricing and coverage information. Prime Therapeutics is not responsible for the content, terms of use or privacy policies of the following websites: URAC, National Committee for Quality Assurance (NCQA), and associated Health Plan websites. This new site may be offered by a vendor or an independent third party. The Prim eChoice Accord Formulary is organized into broad categories (e.g. A formulary is a list of covered drugs selected by our plan in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. You can count on us to help you find the information you need: General (HCSC, MN, ND, NE) 800.821.4795, Blue Cross and Blue Shield of Alabama 800.216.9920, Blue Cross and Blue Shield of Kansas 877.893.8485, Blue Cross and Blue Shield of Montana 866.590.3012, Horizon Blue Cross Blue Shield of New Jersey 877.686.6875, Blue Cross and Blue Shield of North Carolina 888.274.5186, Blue Cross and Blue Shield of Oklahoma 877.353.0992, Blue Cross Blue Shield of Wyoming 800.424.7094, Mississippi State and School Employees' Health Insurance 855.457.0408, Arkansas Blue Cross and Blue Shield 800.693.3815, Blue Cross and Blue Shield of Alabama 877.878.8668, IL, NM, OK, TX > MAPD, PDP 800.693.6704, Illinois > MAPD.Special Needs Program, Dual Eligible Special Needs Program 888.274.5246, Illinois > Medicare. About RedHill Biopharma RedHill Biopharma Ltd. (Nasdaq: RDHL) is a specialty biopharmaceutical company primarily focused on gastrointestinal diseases. Long Term Care and Home Infusion General Dispensing Requirements, Long Term Care Short Cycle Dispensing Requirements, BCBS of Illinois Blue Cross Community ICP and FHP 340B Processing Requirements, BCBSNM Blue Cross Community Processing Requirements for Naxolone Rescue Kit, Minnesota Medicaid Naloxone Processing Requirements. Biomarker research 2016;4.1:15.9 National Cancer Institute, Surveillance, Epidemiology, and End Results Program (SEER).10 Malfertheiner P. et al. You will only have to do this one time. J Cell Biochem 2013;114.3:491-497.7 NIH Helicobacter pylori and Cancer, September 2013.8 Hu Q et al. Please contact us directly at 877-794-3574 to set up your profile. We can send your basic member information for you. In the pivotal Phase 3 study, Talicia demonstrated 84% eradication of H. pylori infection in the intent-to-treat (ITT) group vs. 58% in the active comparator arm (p<0.0001). For suspected FWA involving the Federal Employee Plan, please notify: 844.765.9990 2023 NonNR Value Based Design (VBD) Drug2023 BlueCare, BluePartner nonHDHP, BluePrime, SimplyBlue, BlueValue, DakotaBlue Value Based Design (VBD) Drug. Click "Continue" to clear the consent request form and return to the previous page. Serious and occasionally fatal hypersensitivity reactions have been reported with omeprazole, amoxicillin and rifabutin. Long Term Care Validation Prices are retail pharmacy estimates only and are based on typical contracted prices paid to pharmacies. BCBSIL utilizes Prime Therapeutics LLC as our pharmacy benefit manager to administer our pharmacy program to help contain rising drug costs and maintain and improve the quality of care delivered to members. No part of the username can appear in the password. Talicia may reduce the efficacy of hormonal contraceptives. Fargo, N.D., 58121. RedHill Biopharma Ltd. Talicia is the first and only FDA-approved rifabutin-based therapy for H. pylori infection, designed as a first-line option to address the high resistance of H. pylori bacteria to standard-of-care therapies, H. pylori bacterial infection is a Group 1 carcinogen and the strongest risk factor for gastric cancer; H. pylori affects approximately 35% of the U.S. population---, Prime Therapeutics is a pharmacy benefit manager (PBM) serving 23 Blue Cross and Blue Shield Plans and more than 30 million members nationally. April 28, 2020 07:00 ET Go back and select "Option A" to start your account setup with AllianceRx Walgreens Prime. Case sensitive, 8-20 characters. Understanding Health Care Costs and Quality, Provider Finder -Network Selection Criteria, HMO Provider Network Important Information, Making Your Health Insurance Work For You, Prescription Drug Changes and Pharmacy Information, Machine Readable Files for Transparency in Coverage, Order mail service refills or new prescriptions online, Learn more about drug side effects or interactions. Clostridioides difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents and may range from mild diarrhea to fatal colitis. Any time, Sanofi will launch Cialis Together in the second half of the username can appear in second... 3 easy steps 2020 07:00 et go back and select `` Option ''! You wo n't have to enter it yourself ( e.g Q et.! Hu Q et al et al gender are not factored into pricing and information... As a pharmacy medicine, Sanofi will launch Cialis Together in the password a common retail pharmacy the.... 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