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News for Priority Health Provider Network
December/January 2011-2012

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Select insulins moving to generic copay

Starting Jan. 1, 2012, select insulin products will be available on the employer-sponsored (commercial) formulary for a generic copay!

We’re doing this for two reasons:

  1. It supports our effort to promote the American Diabetes Association’s treatment algorithm for type 2 diabetes, which includes initiation of insulin earlier in the disease course. For a copy of the algorithm, visit priorityhealth.com/provider and select “Clinical resources” and then “Diabetes.”
  2. We’ve heard and listened to your feedback! Because there are no generic insulin products on the market, members don’t have lower cost options within this drug class. And at times, members have difficulty affording their brand copay.

Below is a table that summarizes our coverage of insulin. Please note that effective Jan. 1, 2012, Novo Nordisk brand insulins will be moving to Non-preferred (tier 3). We've sent letters to members impacted by this change. We encourage you to consider switching these members to a generic (tier 1) alternative.

Generic (tier 1)Preferred Brand (tier 2)Non-preferred Brand (tier 3)
Lilly insulin products
(e.g., Humalog, Humulin)
Lantus
Levemir
Apidra
Novo Nordisk insulin products
(e.g., Novolog, Novolin)

Topics: Generics, Diabetes

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