Specialty Drugs means drugs listed on the Approved Drug List meeting certain criteria, such as:
Specialty Drugs means high-cost injectables, infused, oral, or inhaled Prescription Drugs for the ongoing treatment of a chronic condition, including but not limited to, the following: Hemophilia, Hepatitis C, Multiple Sclerosis, Rheumatoid Arthritis, Psoriasis, Crohn’s Disease, Cancer (oral medications), and Growth Hormones. These Prescription Drugs usually require specialized handling (such as refrigeration). Spouse means a person of the same or opposite sex who is legally married to Subscriber under the laws of the state or jurisdiction in which the marriage took place. A marriage legally entered into in another jurisdiction will be recognized as a marriage in the District of Columbia.
Specialty Drugs means high-cost prescription medications used to treat complex, chronic conditions including, but not limited to cancer, rheumatoid arthritis and multiple sclerosis. Specialty Drugs often require special handling (like refrigeration during shipping) and administration (such as injection or infusion). Please contact the Prescription Drug Plan Administrator to determine specific drug coverage.
Examples of Specialty Drugs in a sentence
To the extent required by law, and subject to change as described above, all Covered Drugs indicated for the treatment of Substance Use Disorders are subject to the lowest Coinsurance Amount/Copayment Amount for a Generic Drug, Brand Name Drugs or Specialty Drugs, as applicable.
However, some Specialty Drugs have FDA Approved dosing regimens exceeding the 30-day supply limited and may be allowed greater than a 30 day-supply, if allowed by your plan benefits.
Medical Channel Management Under this program, members will obtain specified Specialty Drugs through the Plan’s Pharmacy Programs rather than through its Medical Programs.
More Definitions of Specialty Drugs
Specialty Drugs mean those scientifically engineered Covered Medications deemed specialty by SOUTHERN SCRIPTS used to treat certain complex and rare medical conditions and are often self-injected or self-administered, which are set forth on Exhibit “B” and may be updated periodically by SOUTHERN SCRIPTS. Claims shall be priced at either the lower of (a) Usual and Customary OR (b) the applicable price formula described below:
Specialty Drugs means Prescription Drugs generally prescribed for use in limited patient populations or diseases. These drugs are typically injected, but may also include drugs that are high cost oral medications and/or that have special storage requirements. In addition, patient support and/or education may be required for these drugs. The list of Specialty Drugs is subject to change. To determine which drugs are Specialty Drugs, a Covered Person should contact his/her Pharmacy, refer to the Drug List by accessing the website at www.bcbsil.com or contact customer service at 1-855-267-0214.
Specialty Drugs means those covered drugs that typically are high in cost and have one or more of the following characteristics: 1) complex therapy for complex disease; 2) specialized patient training and coordination of care (services, supplies, or devices) required prior to therapy initiation and/or during therapy; 3) unique patient compliance and safety monitoring requirements; 4) unique requirements for handling, shipping and storage; and 5) potential for significant waste due to the high cost of the drug. In addition, a follow-on-biologic or generic product will be considered a Specialty Drug if the innovator drug is a Specialty Drug.
Specialty Drugs means high-cost injectables, infused, oral or inhaled Prescription Drugs that:
Specialty Drugs means drugs determined by the department pursuant to subdivision (f) of Section 14105.3 to generally require special handling, complex dosing regimens, specialized self-administration at home by a beneficiary or caregiver, or specialized nursing facility services, or may include extended patient education, counseling, monitoring, or clinical support.
Specialty Drugs means biotechnical drugs that are oral, injectable, infused or inhaled medications that are either self-administered or administered by a health care provider and used or obtained in either an outpatient or home setting. "Spinal Manipulative Services/Chiropractic Treatment" means treatment of the musculoskeletal system through sublimation, manipulation or other similar treatments including medical diagnostic testing to determine necessity of treatment prescribed by a Physician.
Specialty Drugs means a high cost prescription drug that meets any of the following criteria: