Olmesartan/olmesartan HCTZ, generic versions of Benicar®/Benicar HCT®, came to the market in October of 2016. At that time, generic prices were high, so Blue Cross and Blue Shield of North Carolina (Blue Cross) made the decision to prefer brand Benicar over generic olmesartan for utilization management and formulary tier placement.
On May 1, 2017, Blue Cross will prefer generic olmesartan. This means:
Brand Benicar will require step therapy, but generic olmesartan will not. Both formulations will continue to have a quantity limit.
- If a member wants to continue taking brand Benicar, providers must submit a request for review. No request will be needed if the member can take the generic.
- Brand Benicar will be placed in the brand tier, and generic olmesartan will remain in generic tiers on formularies.
If a member has a prescription for brand Benicar, they will automatically be switched to generic olmesartan at the pharmacy. No additional information will be needed from you. If, however, you would like your member to continue receiving the brand drug, Blue Cross will need additional information in order to approve this request. Details can be found on our website at https://www.bcbsnc.com/content/providers/ppa/prescriptions.htm.
These updates do not apply to the State Health Plan, the Federal Employee Program, Medicare Part D members, or any self-funded employer groups that carve out their pharmacy benefits to another pharmacy benefits manager.
Please call the Provider Blue LineSM, at 1-800-214-4844, with any questions.