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Sep 1, 2018

ADHD stimulant-formulary coverage update

Effective October 1, 2018, the BCBSRI Pharmacy Formulary will be updated to remove the generic equivalent versions for Adderall XR and Concerta from the formulary. Amphetamine/Dextroamphetamine mixed salts and Methylphenidate HCL ER will be designated as non-formulary.

All members who have existing use of the generic product received a notification letter with information suggesting use of the brand version product, which is available at a preferred brand copayment. Any member with an existing authorization for use of the generic will not be impacted by this formulary update. Notifications were distributed to the members on August 1, 2018.

While the brand version has been the preferred formulary product previously, many members are being dispensed the generic version due to pharmacy substitution practices and are paying a higher out-of-pocket expense than necessary.