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Compond Drugs - Prior Authorization

Starting October 1, Compound Drugs Will Require Prior Authorization

Our prescription drug plan covers medication approved by the U.S. Food and Drug Administration (FDA), prescribed by a doctor and medically necessary. The plan has a “prior authorization” procedure where CVS Caremark reviews prescriptions and contacts your doctor when the medical need for a drug is not apparent.

Because of increased utilization of compound drugs, beginning October 1, 2014, CVS Caremark will apply the “prior authorization” procedure to compound drugs. Compound drugs are prepared by combining or altering ingredients of two or more FDA-approved drugs to create a new customized drug that is not commercially available. There are instances in which the use of a compound drug is an appropriate medical treatment. Examples of this are infants who need a drug with a limited-strength dosage or patients who cannot take certain commercially prepared prescriptions.

If the medication currently being prescribed to you is not approved by CVS Caremark, you may want to ask your doctor whether an alternative FDA-approved covered prescription drug is available.

For more information regarding compound drug coverage, please contact CVS Caremark at 1-800-601-6364.

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