There are multiple generic medications available to treat high blood pressure. Medical guidelines support using one of the generic drugs before using a brand-name angiotensin converting enzyme inhibitor (ACE Inhibitor), angiotensin-II receptor blocker (ARB) or renin inhibitor (RI). Formulary and non-formulary brand-name drugs will require a prior authorization unless one of the available generic drugs has been tried first. An electronic claim edit at the pharmacy will determine if a member has been receiving the brand-name medication or has tried a required generic. In either case, the requested brand-name drug will be approved. Members new to BCBSKS prescription drug coverage will not have a claim history to automatically approve the brand-name drugs. Therefore, a prior authorization process is in place to provide a manual review of claims that do not meet the electronic edit.
The table below shows the generic drugs available, as well as, the brand-name drugs that will require a prior authorization if a generic has not been used.
| Brand Medications Requiring Prior Authorization | Generic Medications |
|---|---|
ACE Inhibitors & Combinations Accupril, Accuretic, Aceon, Altace, Capoten, Capozide, Lexxel, Lotensin, Lotensin HCT, Lotrel, Mavik, Prinivil, Prinzide, Tarka, Univasc, Uniretic, Vaseretic, Vasotec, Zestril, Zestoretic |
|
ARB & Combinations Atacand, Atacand HCT, Avalide, Avapro, Azor, Benicar, Benicar HCT, Cozaar, Diovan, Diovan HCT, Edarbi, Exforge, Exforge HCT, Hyzaar, Micardis, Micardis HCT, Teveten, Teveten HCT, Tribenzor, Twynsta, |
|
RI & Combinations Amturnide, Tekamlo, Tekturna, Tekturna HCT, Valturna |