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-12Drug NameGPI NameTherapeutic Category
PENDINGABRILADAAdalimumab-afzbAnti-TNF-alpha - Monoclonal Antibodies
665000700020ACTEMRATocilizumab IV InjInterleukin-6 Receptor Inhibitors
303000100040ACTHAR HPCorticotropin Inj GelCorticotropin
217000607020ACTIMMUNEInterferon Gamma-1B InjAntineoplastics Miscellaneous
651000251084ACTIQFentanyl Citrate LollipopOpioid Agonists
856010100021ACTIVASEAlteplase for InjThrombolytic Agents
828070207020ADAKVEOCrizanlizumab-tmca IV SolnBlood Form, Coag, and Thromb Agent
9027308045E5ADBRYTralokinumab-ldrm Subcutaneous SolnSkin and Mucous Membrane Agents, Misc
213532202021ADCETRISBrentuximabAntineoplastic
401430800003ADCIRCATadalafil TabPulmonary Hypertension - Phosphodiesterase Inhibitors
621750300003ADDYIFlibanserinMixed Serotonin Agonist/Antagonist
401340500003ADEMPASRiociguat TabPulmonary Hypertension - Soluble Guanylae Cyclase (sGC) Stimulator
61200070100310ADIPEX-P (brand only)Phentermine HCl Tab 37.5 MGAnorexigenic Agents
2717005600ADLYXINLixisenatide Soln Pen-injectorIncretin Mimetics
PENDINGADSTILADRINNadofaragene firadenovec-vncg SuspGene Therapy
620505101020ADUHELMAducanumab-avwa IV SolnCentral Nervous System Agents, Misc
851000102521ADVATEAntihemophilic Factor rAHF-PFMAntihemophilics
851000104021ADYNOVATEAntihemophilic Factor Recomb Pegylated for InjAntihemophilics
16000048200620AEMCOLORifamycin Sodium Tab Delayed ReleaseAntibacterials, Miscellaneous
215325300003AFINITOREverolimus TabAntineoplastic Enzyme Inhibitors
215325300073AFINITOR DISPERZEverolimus Tab for Oral SuspAntineoplastic Enzyme Inhibitors
271040100029AFREZZAInsulin Regular (Human) Inhalation PowderDiabetes
271040100029AFREZZAInsulin Regular (Human) Inhalation PowderDiabetes
851000105564AFSTYLAAntihemophilic Fact Rcmb Single Chain for InjAntihemophilics
6770202010D5AIMOVIGErenumab-aooe Subcutaneous Soln Auto-InjectorAntimigraine Agents
6770203020E520AJOVYFremanezumab-vfrm Subcutaneous Soln Pref SyrAntimigraine Agents

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