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1-100: Managing Specialty Drugs

Sep 30, 2016

A Better Way to Manage Specialty Drugs 

Health care costs continue to rise, and specialty drugs are a big contributor. These prescription medicines are used to treat complicated and chronic conditions, such as hepatitis C, cancer and multiple sclerosis. As specialty drugs become more widely used, Anthem is looking for new ways to control costs while keeping members healthy. That’s why Anthem created their ​Right Drug Right Channel (RDRC) program

Anthem will now offer two Right Drug Right Channel programs beginning January 1, 2017: 

  1. ​​Right Drug Right Channel Medical to Pharmacy: Certain self-administered drugs that were covered under the medical benefit will now be covered under the pharmacy benefit.
  2. ​NEW! Right Drug Right Channel Pharmacy to Medical: Certain specialty drugs that were covered under the pharmacy benefit will now be covered under the medical benefit. This is a new program that will be offered in addition to the Right Drug Right Channel Medical to Pharmacy program. 

Anthem's Right Drug Right Channel programs ensure: 

In the coming weeks, Anthem will be reaching out to group members affected by this change. If these members don’t have pharmacy coverage with Anthem through their employer, they will need to contact their pharmacy provider for coverage information for drugs moving from medical to pharmacy. 

If a member believes this change poses a hardship, he or she and/or the member’s doctor can ask us to keep covering the drug(s) under the member’s pharmacy benefit by submitting a request for an exception by calling us at the number on the member’s ID card. 

For questions, please contact a member of your b&p Sales Team - 888.722.3373.

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