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12/14/2016 RC-- Invega Sustenna Reimbursement Changes

From: Richard Cramer

To: Pharmacy

Sent: Wednesday, December 14, 2016 6:59:33 AM

Subject: Invega Sustenna Reimbursement Changes

The Invega Sustenna program has changed its rules recently.  Currently, each patient is now permitted 2 replaceable doses of Invega Sustenna per CALENDAR year (i.e Jan-Dec) at each institution, no matter what strengths are used.  Additionally, they are only replacing drug now for orders written by psychiatrists, although this new policy is being re-evaluated.  That means orders written by our ER physicians won't be reimbursed, and the 234 mg dose costs $1,500.  For orders from the ER, or from non-psychiatrists, please attempt to get the order signed off by a psychiatrist, or obtain a verbal order from the psychiatrist instead of the other physician signing the order.  A psychiatrist should be involved at some level in deciding to give a dose here.   Let me know if you have any questions.  

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Richard Cramer, Pharm. D., FASHP, BCGP

Drug Information Coordinator