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1+: Certain Compound Drugs No Longer Covered by Anthem

Sep 15, 2015

Starting November 4, 2015, Anthem's prescription drug plans will no longer pay for certain compound drugs that contain ingredients not approved by the Food and Drug Administration (FDA). A compound drug is a customized medication prepared by a pharmacist for a specific person. Some of your employees may be affected by this change, if they are taking one of these drugs, particularly ones containing:

For a compound drug to be covered by one of Anthem's plans, it must contain only FDA-approved ingredients (with some exceptions for ingredients essential to compound administration). A prescription is also required for the drug. These control measures are in place to protect Anthem's members and to help make sure compound drugs are safe and effective to use.

Anthem will continue to cover compound drugs with ingredients that are FDA-approved and not otherwise excluded, as defined under the plan.

How Anthem will notify impacted members
Anthem will let their impacted members know about this change 60 days in advance. The next time they fill a prescription for one of these drugs, they may have to pay the full cost for it. They can talk to their doctors to find out if there's another covered drug that would work as well for them.

Here's a sampl​e of the letter members will receive.

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

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