In an effort to support continued access to affordable prescription drug benefits, MedImpact Healthcare Systems, Inc., on behalf of participating plans, will preferentially cover the brand version of LIALDA when the generic becomes available in the market. Under this initiative, we will request pharmacies to dispense brand name LIALDA prescriptions from when the generic is released (approximately early August 2017) to approximately end of 2017 (with the possibility of extending it to early 2018) for members of participating plans. Pharmacies will continue to receive brand reimbursement for these fills.
 
To enable the pharmacist to determine which members are in a participating plan, the NDCs for the generic (MESALAMINE DELAYED RELEASE) will be blocked from adjudicating on claims for those members. The claim rejection response will contain a message reminding the pharmacist that they should dispense brand LIALDA to the member.  
 
If pharmacies need a DAW code to bypass internal edits, DAW code value 9 can be used:

• For D.0 claim submissions, DAW 9 means Substitution Allowed By Prescriber but Plan Requests Brand - Patient's Plan Requested Brand Product to Be Dispensed.  

• If pharmacy is still submitting 5.1 claims, the use of DAW 9 – Other is recommended.  
 
MedImpact clients, their members, and prescribers have been notified of this change.
 
If you have any questions concerning this letter, please contact a MedImpact representative at 1800-788-2949.
 

Sincerely, 
MedImpact Healthcare Systems, Inc.