On March 29, 2017, generic Advair Diskus (fluticasone-salmeterol inhalation powder) is expected to become available in the market. Fluticasone-salmeterol inhalation powder will remain Non-Formulary for Medicare Part D Covered Persons. The innovator product Advair Diskus will continue to be covered without prior approval* from the plan.
Action Required
If Participating Pharmacies receive a prescription for fluticasone-salmeterol inhalation powder for a Medicare Part D Covered Person, they will need to submit brand name Advair Diskus in order to receive a paid claim. If a prescription for fluticasone-salmeterol inhalation powder is submitted instead of brand name Advair Diskus, the claim will reject at point-of-sale (POS) with the following reject message: NCPDP
- Reject Code MR: Drug Not on Formulary
- Secondary Message: Advair Diskus is formulary, fluticasone-salmeterol inhalation powder is non-formulary
For questions regarding coverage of Advair Diskus or the new product, please refer Covered Persons to the Customer Service number on the back of their insurance card.
If you have any questions regarding claims processing, please call the Prime Contact Center at 800.821.4795.
Sincerely,
Pharmacy Network Management
Prime Therapeutics LLC
* Coverage of Advair Diskus is dependent on the Covered Person’s benefit plan.