Hospira, Inc. Issues a Voluntary Nationwide Recall for 4.2% Sodium Bicarbonate Injection, USP and 1% and 2% Lidocaine HCl Injection, USP Due to the Potential for Presence of Glass Particulate Matter
October 2, 2023
Drug Quantity Management Program
October 5, 2023
Hospira, Inc. Issues a Voluntary Nationwide Recall for 4.2% Sodium Bicarbonate Injection, USP and 1% and 2% Lidocaine HCl Injection, USP Due to the Potential for Presence of Glass Particulate Matter
October 2, 2023
Drug Quantity Management Program
October 5, 2023

BeneCard PBF's clinical review program utilizes online claim adjudication edits to prevent claim payment until BeneCard PBF has assessed the patient’s drug history and/or current diagnosis through communication with the member’s physicians to ensure appropriate and safe utilization of the medication. Drugs requiring clinical review are associated with a diagnosis-based drug utilization protocol that is used to determine coverage. These protocols are based on clinical information, clinical trials, and industry standards, as well as pharmaceutical compendia such as Micromedex, Facts & Comparison, and AHFS proving for clinically appropriate and sound evidence-based medical standards. Rationale for requiring that a product undergo clinical review before adjudication relates to the following issues: safety, off-label use, product availability/rationing, and special request by the client. One or more of these characteristics could predispose a medication to clinical review status.

GPI-12 Drug Name GPI Name Therapeutic Category
PENDING ABRILADA Adalimumab-afzb Anti-TNF-alpha - Monoclonal Antibodies
665000700020 ACTEMRA Tocilizumab IV Inj Interleukin-6 Receptor Inhibitors
303000100040 ACTHAR HP Corticotropin Inj Gel Corticotropin
217000607020 ACTIMMUNE Interferon Gamma-1B Inj Antineoplastics Miscellaneous
651000251084 ACTIQ Fentanyl Citrate Lollipop Opioid Agonists
856010100021 ACTIVASE Alteplase for Inj Thrombolytic Agents
828070207020 ADAKVEO Crizanlizumab-tmca IV Soln Blood Form, Coag, and Thromb Agent
9027308045E5 ADBRY Tralokinumab-ldrm Subcutaneous Soln Skin and Mucous Membrane Agents, Misc
213532202021 ADCETRIS Brentuximab Antineoplastic
401430800003 ADCIRCA Tadalafil Tab Pulmonary Hypertension - Phosphodiesterase Inhibitors
621750300003 ADDYI Flibanserin Mixed Serotonin Agonist/Antagonist
401340500003 ADEMPAS Riociguat Tab Pulmonary Hypertension - Soluble Guanylae Cyclase (sGC) Stimulator
61200070100310 ADIPEX-P (brand only) Phentermine HCl Tab 37.5 MG Anorexigenic Agents
2717005600 ADLYXIN Lixisenatide Soln Pen-injector Incretin Mimetics
PENDING ADSTILADRIN Nadofaragene firadenovec-vncg Susp Gene Therapy
620505101020 ADUHELM Aducanumab-avwa IV Soln Central Nervous System Agents, Misc
851000102521 ADVATE Antihemophilic Factor rAHF-PFM Antihemophilics
851000104021 ADYNOVATE Antihemophilic Factor Recomb Pegylated for Inj Antihemophilics
16000048200620 AEMCOLO Rifamycin Sodium Tab Delayed Release Antibacterials, Miscellaneous
215325300003 AFINITOR Everolimus Tab Antineoplastic Enzyme Inhibitors
215325300073 AFINITOR DISPERZ Everolimus Tab for Oral Susp Antineoplastic Enzyme Inhibitors
271040100029 AFREZZA Insulin Regular (Human) Inhalation Powder Diabetes
271040100029 AFREZZA Insulin Regular (Human) Inhalation Powder Diabetes
851000105564 AFSTYLA Antihemophilic Fact Rcmb Single Chain for Inj Antihemophilics
6770202010D5 AIMOVIG Erenumab-aooe Subcutaneous Soln Auto-Injector Antimigraine Agents
6770203020E520 AJOVY Fremanezumab-vfrm Subcutaneous Soln Pref Syr Antimigraine Agents

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