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Prescription Drugs

Specialty drug pharmacies

Specialty drugs are medications that may have additional coverage requirements and can only be filled at certain pharmacies.

Specialty pharmacy FAQ

Specialty medications are most commonly used for chronic diseases such as rheumatoid arthritis and multiple sclerosis. These drugs are generally high-cost drugs, ranging from approximately $6,000 to $350,000 per patient, per year. Most specialty drugs are injectable and require special handling and administration. Specialty drugs are not limited to a specific copayment or coinsurance tier, but can be found in all formulary tier levels.

In recent years, the use of specialty drugs has increased significantly and along with that, the cost of covering those drugs. To ensure that specialty drugs remain affordable for our members, Blue Cross NC has contracted with a new network of pharmacies committed to providing better pricing on specialty medications.

No, specialty medications are all name brands and not currently available as a generic.

Specialty pharmacy support

A patient's specific health plan determines which specialty pharmacies they should use. If patients have questions about pharmacies or specialty drugs, they are encouraged to call the customer service number listed on their member ID card.

For provider-specific questions about eligibility, benefits, claims, and more, please contact our team.