ConnectiCare | Office Visit - March 2017
March 2017 Office Visit

In this issue

How we're trying to improve medication adherence
Epinephrine update: New auto-injectors now available
Your advice matters! Help get more people screened for colon cancer
Has any of your information changed? Let us know.
Recent provider headlines

How we're trying to improve medication adherence

Express Scripts, our pharmacy benefits manager, is helping identify members who may not be taking their medication as prescribed and contacting them by mail or by phone to offer help, such as:

Switching to less-expensive drugs or generics
Syncing refills so a member can pick up all refills at the same time
Prescribing 90-day supplies to minimize trips to the pharmacy
Providing information on available financial help
Enrolling members in refill reminders, automated refills and prescription home delivery
Suggesting other routines to help members remember to take their medicines

Express Scripts pharmacists and staff are trained in how talk to members who may be risking their own or their children's health by not taking their medications as directed. Members who have questions can always call Express Scripts for answers and support.

Here are some resources you may be interested in:

Details about the Express Scripts program
The Costs of Nonadherence

Epinephrine update: New auto-injectors are now available

New "authorized generics" for epinephrine auto-injectors are now available to your patients. The average costs of the new medications are $110 to $375 for two auto-injectors, compared with $600 for EpiPen®. Members' out-of-pocket costs will depend on their plan benefits.

The authorized generics for epinephrine auto-injectors that have been recently released are:

An epinephrine auto-injector from Mylan Pharmaceuticals (which also manufactures EpiPen) is in the preferred brand tier. This is the same tier placement as the brand EpiPen.
Adrenaclick® (made by Amedra Pharmaceuticals/Impax Laboratories) is in the non-preferred brand tier. Adrenaclick is currently only available at CVS stores, and it is not certain if supply can meet the anticipated demand.

Though the drugs are classified as authorized generics, they are still only available from the same manufacturers as the brand-name medications.

Doctors need to specify an authorized generic medication and strength when prescribing. Here’s a chart summarizing the tier placement for all epinephrine auto-injectors.

What this means for your patients
Patients filling prescriptions for epinephrine auto-injectors are responsible for the co-payments/co-insurance and deductibles defined by their plans. Members with pharmacy deductibles will benefit from using the new authorized generics due to their lower costs.

Auto-injector from Auvi-Q is re-released
Auvi-Q® is an auto-injector that is smaller than the EpiPen — about the size of a credit card and as thick as a smartphone — and has audio instructions for injection. It was pulled from the market in 2015 over concerns that it wasn't delivering a reliable dose. It has now been reintroduced.

Due to the high price — about $4,500 for two injectors — Auvi-Q is in the non-preferred brand tier in ConnectiCare formularies. When doctors prescribe Auvi-Q, we will require preauthorization and step therapy.

Your advice matters! Help get more people screened for colon cancer

In recognition of Colon Cancer Awareness Month, please help us get more people screened for the disease. More people get their screening done when their doctors recommend it.

A survey done by the American Cancer Society found that 90 percent of people who reported that their doctor recommended getting the test done actually got screened.

Colon Cancer

Too many people avoid being screened for colon cancer, even though annual screenings after the age of 50 are covered 100 percent by their plans as a preventive service. You can help!

Here's what you can do:

Use the "Gaps in Care" reports we send you to follow up with your ConnectiCare patients who have not had the screening done yet.
Talk to your patients about why they have not had the screening and address their concerns.
If your patients refuse to have a colonoscopy, recommend the fecal immunochemical test (FIT) instead. If you need a supply of FIT tests, contact the lab you work with or call Quest at 1-866-MYQUEST.

Has any of your information changed? Let us know.

Check our provider directory to make sure we have the right information for you and your practice. Our members rely on our provider directory to find doctors like you quickly and easily.

Relevant changes include your:

tax ID number
national provider identification (NPI)
phone number
office hours
ability to accept new patients

Submit any changes by filling out our provider information update form and sending it back to us as noted on the form.

Recent provider headlines

Check out the latest Provider News & Headlines:

Claims payment policies updated as of Jan. 31, 2017 (chiropractic information updated)
Submit taxonomy codes to help make sure claims are paid quickly
Update on Medicare Advantage EOPs and ERAs
Commercial medical record reviews have started
Reminder: Use new Medicare Advantage ID numbers

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