Generic Inhaler Update

Generic Inhaler Update

May 7th, 2018 | Clinical ConnectionsNews

As you may have read in the most recent issue of AHP5 or heard at the March Clinical Grand Rounds event, AHP is encouraging providers to switch patients covered under certain health plans to the newly available generic inhaler, fluticasone/salmeterol RespiClick. Many AHP providers have taken action to make that change for patients but have encountered a number of obstacles related to insurance coverage. As a network we want to take this opportunity to recommend an approach that avoids those obstacles and to clarify how our market’s major payers cover fluticasone/salmeterol RespiClick.

This initiative focuses on switching in patients with an Excellus Commercial, Excellus Medicaid Managed Care or MVP Commercial pharmacy benefit. For patients covered by these products, this generic inhaler (fluticasone/salmeterol RespiClick) is covered and should not require a prior authorization. To assist you with a targeted approach for switching only those patients, we will be sending a secure list to your AHP care manager of patients covered by these health plans who were dispensed another inhaler in the same drug class in the last four months. If you do not have an AHP care manager and would like your patient list, please email Jenny Radcliffe.

Unfortunately, there is not yet universal coverage for this medication. At present, Medicare appears to be the most problematic, and there are some commercial and Medicaid payers not yet covering. See the table below for info about coverage under our market’s major payers.

Thank you for your efforts to work with AHP on this important initiative. Please contact Jenny Radcliffe if you have more specific questions or feedback.