There are two changes to the Express Scripts Network Provider Manual outlined below.

Dear Valued Provider, Effective February 12, 2016, Blue Cross and Blue Shield of Alabama (BCBSAL) will be changing Nexium® to a Tier 3 covered drug*. This change is due to more generic versions of Nexium® (esomeprazole magnesium) being available on the market. If a Participating Pharmacy submits a claim for Nexium® for a Covered Person, the claim will process at a Tier 3 copayment compared to Tier 1 copayment for esomeprazole magnesium.

Dear Pharmacy,  

In an effort to support continued access to affordable prescription drug benefits, PEEHIP has elected – on a temporary basis - to preferentially cover the brand version of NEXIUM over generic ESOMEPRAZOLE MAGNESIUM for PEEHIP’s non-Medicare eligible members. Per PEEHIP’s direction, we request pharmacies to dispense brand name NEXIUM for all new and refill ESOMEPRAZOLE MAGNESIUM prescriptions from 04/01/15 to at least 08/18/15 for Alabama non-Medicare eligible PEEHIP members. Pharmacies will continue to receive brand reimbursement for these fills.  

In February 2015, generic Nexium® (Esomeprazole) became available in limited supplies to pharmacies. Currently it has been estimated that production of Esomeprazole will supply less than 25% of the need over the next several months until production increases. Due to the limited supply of Esopmeprazole in the market place, both generic Esomeprazole and the brand Nexium® will be covered by Florida Blue at the same tier.*