Provider updates

PA Removed for Pregabalin (generic Lyrica)

By Cory Bradley, PharmD

The long-awaited release of generic Lyrica occurred in the Summer of 2019. With a number of manufacturers immediately making the capsules, the price rapidly decreased by over 90% in the remaining months of 2019. CareOregon’s Pharmacy & Therapeutics Committee officially evaluated and approved the removal of the prior authorization requirements, effective April 1, 2020. CareOregon expects similar utilization to what is experienced with gabapentin, with thousands of potential members getting their prescriptions covered. In anticipation of seeing similar safety problems, CareOregon will institute two new safety edits to help ensure safe utilization of pregabalin:

• A cumulative quantity limitation to prevent multi-strength and/or multi-prescriber prescription overlap. Prior authorization is required if multi-strength use is continued.

  
  

• A soft-rejection warning to dispensing pharmacists to call attention to cross gabapentin-pregabalin utilization.