Stimulant medication shortages
Mar. 2023Pharmacy Updates
"UPMC Health Plan has become aware of shortages for generic stimulant medications used to treat attention-deficit/hyperactivity disorder. We wanted to provide details on how your patients (our members) may navigate these shortages since we are not sure how long they will last.
Through outreach, we have learned that most pharmacies have or can acquire brand-name versions of these drugs. If a patient’s pharmacy does not have one of the generic medications listed below, a one-time override for the noted generic’s brand counterpart may be requested by you, your patient, or the patient’s pharmacy. This process is applicable to all lines of business.
In the case of UPMC Health Plan Commercial members, brand claims may pay without an override but with higher out-of-pocket costs. To avoid this financial burden on our members, please reach out for an override. With the override, the cost for brand would be the same as generic for a Commercial member whose plan does not have a deductible or whose deductible has already been met.
To obtain overrides or to ask questions, providers can call Pharmacy Services at 1-800-979-8762. Pharmacies can call the Pharmacy Help Desk at 1-800-396-4139 and follow the prompts to speak with the Health Plan. Members can call the Member Services phone number on their member ID card.
We understand that this process is time consuming, but our shared goal is member and patient satisfaction. We will continue to monitor the situation and provide updates accordingly."
Through outreach, we have learned that most pharmacies have or can acquire brand-name versions of these drugs. If a patient’s pharmacy does not have one of the generic medications listed below, a one-time override for the noted generic’s brand counterpart may be requested by you, your patient, or the patient’s pharmacy. This process is applicable to all lines of business.
- Amphetamine salts immediate-release tablet, dextroamphetamine-amphetamine immediate-release tablet (generics for Adderall tablet)
- Dextroamphetamine-amphetamine extended-release capsule (generics for Adderall XR capsule)
-
Methylphenidate extended-release tablet (generics for Concerta tablet)
- Note: Brand Concerta is preferred on the Statewide Preferred Drug List for Medical Assistance and Community HealthChoices, so an override should not be needed for members with primary coverage through UPMC for You or UPMC Community HealthChoices.
In the case of UPMC Health Plan Commercial members, brand claims may pay without an override but with higher out-of-pocket costs. To avoid this financial burden on our members, please reach out for an override. With the override, the cost for brand would be the same as generic for a Commercial member whose plan does not have a deductible or whose deductible has already been met.
To obtain overrides or to ask questions, providers can call Pharmacy Services at 1-800-979-8762. Pharmacies can call the Pharmacy Help Desk at 1-800-396-4139 and follow the prompts to speak with the Health Plan. Members can call the Member Services phone number on their member ID card.
We understand that this process is time consuming, but our shared goal is member and patient satisfaction. We will continue to monitor the situation and provide updates accordingly."
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