2010 Formularies now available. Please see below: December 1, 2009
Posted by admin in : Pharmacy Updates , trackbackDear Provider,
The 2010 Health New England (HNE) formularies are is now available on line at hne.com. Formularies available include:
- The HNE Formulary for our three-tiered pharmacy benefit package lists our Tier I (Generic) and Tier II (Preferred Brand) drugs. Medications not listed on the formulary default to Tier III (Non-Preferred Brand).
- The HNE Performance Formulary is our innovative, 2-Tier pharmacy benefit. Tier 1 includes all generic drugs. Tier 2 includes specific brand name drugs carefully selected based on clinical efficacy and cost efficiency. This HNE Performance Formulary rider is sold only with a limited number of plans.
- The HNE Medicare Advantage Formulary – exclusively for members enrolled in our Medicare Advantage plans with pharmacy coverage
- The HNE Be Healthy Formulary – exclusively for members enrolled in our MassHealth plans.
The formulary also lists of medications with
- Quantity limitations
- Step therapy requirements (i.e., a trial of a generic drug in that class),
- Prior-authorization requirements.
We have forms available for your use when prescribing these medications. Completing the form can avoid delays in our review process by ensuring that we have all the information we need to make a decision. You can obtain forms on the HNE website, hne.com, or by contacting HNE Member Services at 1-800-310-2835. You also may request prior authorization by calling our designated Prior Authorization line at 1-888-806-4998.
The HNE online formulary is updated throughout the year as changes are made to the formulary.
Please consider the cost differential between each tier when prescribing. For example, under the HNE Formulary, copayments vary by plan; however, in general, the copayment differential between Tier II and Tier III is at least $15.00/month, The difference between Tier I and III is at least $35.00/month. By using generic drugs or prescribing therapeutic equivalents at a lower tier level, you can significantly reduce costs to your patients. Lower costs often translate to enhanced medication compliance. HNE covers at least one therapeutic agent for each disease state at the Tier I and Tier II levels.
We appreciate your continued partnership in providing access to high-quality, affordable care to our community here in Western Massachusetts. If you have any questions, please call your Provider Relations representative at 413-787-4000.
Sincerely,
Donna L. O’Shea, M.D.
Associate Medical Director
Comments»
no comments yet - be the first?