Humana Changes Drug List and Dispensing Limits

Humana made changes to its Rx3 and Rx4 Drug Lists and two-tier, Rx3 and Rx4 dispensing limits for its commercial prescription drug benefit plans effective January 1, 2005. Drugs may have been added, deleted or moved to a different level on the Drug List.

Drug level changes mean that Humana members still have access to the drug, but they may be required to pay a higher copayment than they paid in 2004. Some of the products that moved from Level 2 to Level 3 include Plavix and select brand anti-epileptics (seizure medications). Those changes are reflected in the chart.

New dispensing limits (a maximum allowable quantity that Humana will cover for one retail copayment) will be assigned to drugs on Humana’s two-tier, Rx3 and Rx4 Drug Lists. The new dispensing limits represent typical dosage selections and quantities recommended by the U.S. Food and Drug Administration (FDA). The following drug classes will include drugs that require dispensing limits:

1. Anti-epileptics
2. Blood pressure/heart
3. Cholesterol
4. Mental disorders
5. Migraine
6. Nausea/vomiting
7. Pain
8. PPI/heartburn
9. Vaginal antifungal

The complete Drug List can be found on Humana’s Web site at www.humana.com.

After logging on to the site, click on “Providers,” “Prescription Tools and Resources,” “Prescription Tools” and then “Drug Lists and Forms.” You can also access prior authorization forms, specialty injectable medication patient referral forms and information about dispensing limits via the Web site. In addition, personal digital assistant (PDA) users can access Drug List information through ePocrates Rx(r). For information about ePocrates, visit www.epocrates.com.

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