New Blue RX Drug Plan Takes Effect 2017

In the last round of bargaining, improving the drug coverage for members was one of the highest priorities for the BC Nurses' Union. This was achieved in the 2014-2019 Provincial Collective Agreement which includes a change in drug plan to Blue RX, a drug formulary managed by Pacific Blue Cross (PBC). By negotiating this superior coverage, BCNU has secured members' access to an expanded formulary that includes almost double the number of drugs, effective January 1, 2017.

This is excellent news for nurses, as it ensures they will have access to key drugs not covered under the current plan. In fact, under the new Blue RX plan, the majority of prescription drugs in Canada will be automatically covered. Many drugs that are not covered under the current plan will be automatically eligible for coverage, while others no longer require Special Authority approval. Some examples of drugs that will be automatically available for coverage, effective January 1, 2017, include:

• Duloxetine (Cymbalta™)
• Zopiclone (Imovane™)
• Pregabalin (Lyrica™)
• Montelukast (Singulair™)
• Tramadol HCL/Acetaminophen (Tramacet™)

No nurse will lose coverage as a result of the change in drug plan

Additionally, coverage of any drugs grandparented under the Pharmacare tie-in arbitration award will continue under Blue RX. If you already have Special Authority approval from BC Pharmacare (and have submitted a copy of the approval to PBC), coverage of that drug will continue under Blue Rx ? there is no need to request further approvals.

Prior Approvals required for some drugs

There are a small number of select drugs that will require some form of pre-approval before being covered.

LIST OF DRUGS REQUIRING PRIOR APPROVAL

LIST OF DRUGS REQUIRING SPECIAL AUTHORITY

Detailed information about the Blue RX drug plan for nurses, including how to obtain Prior Approval and Special Authority, is available at the PBC website, www.pac.bluecross.ca/pca.

For all pre-approval drugs, if you receive approval for a drug within 90 days after you filled your prescription (on or after January 1, 2017) you will be reimbursed for one claim.

Prior Approval Request Forms are now being accepted by PBC for review, to ensure members receive coverage of these drugs at the earliest possible date (January 1, 2017).

If you have specific questions about your drug coverage, please call:

Pacific Blue Cross Pharmacy Services
Phone: 1-877-PAC-BLUE
Email: pharmacyservices@pac.bluecross.ca
(emails MUST INCLUDE policy, identification number and phone number)