Accredo Split-Fill Drug List

January 2018 1199SEIU Benefit Funds Split-Fill Drug List

  • The specialty drugs on the Accredo Split-Fill list will be dispensed as a 14- or 15-day supply for six (6) consecutive fills during the initial three (3) months of drug therapy.
  • The specialty drugs are dispensed as a 14- or 15-day supply to allow drug dosage adjustments and/or changes in drug therapy, to promote clinical drug therapy management.
  • If a member remains on the specialty drug for longer than three (3) months, Accredo will fill a 30-day supply on the fourth (4th) month of drug therapy.
DrugsDays Supply RuleDisease State
ALECENSA6 fills of 15 daysOncology
BOSULIF6 fills of 15 daysOncology
CABOMETYX6 fills of 15 daysOncology
COPEGUS6 fills of 15 daysHepatitis C
DAKLINZA6 fills of 14 daysHepatitis C
EPCLUSA6 fills of 14 daysHepatitis C
ERIVEDGE6 fills of 15 daysOncology
EXJADE6 fills of 15 daysIron Toxicity
GLEEVEC (imatinib)6 fills of 15 daysOncology
HARVONI6 fills of 14 daysHepatitis C
ICLUSIG6 fills of 15 daysOncology
INCIVEK6 fills of 14 daysHepatitis C
INLYTA6 fills of 15 daysOncology
IRESSA6 fills of 15 daysOncology
JADENU6 fills of 15 daysIron Toxicity
JAKAFI6 fills of 15 daysOncology
KALYDECO6 fills of 15 daysCystic Fibrosis
LENVIMA6 fills of 15 daysOncology
LYNPARZA6 fills of 14 daysOncology
MAVYRET6 fills of 14 daysHepatitis C
MODERIBA6 fills of 15 daysHepatitis C
NERLYNX6 fills of 15 daysOncology
NEXAVAR6 fills of 15 daysOncology
NUPLAZID6 fills of 15 daysParkinson’s Disease
OLYSIO6 fills of 15 daysHepatitis C
PEGASYS6 fills of 15 daysHepatitis C
REBETOL6 fills of 15 daysHepatitis C
RIBAPAK6 fills of 15 daysHepatitis C
RIBASPHERE6 fills of 15 daysHepatitis C
RIBATAB6 fills of 15 daysHepatitis C
RIBAVIRIN6 fills of 15 daysHepatitis C
SOVALDI6 fills of 14 daysHepatitis C
SPRYCEL6 fills of 15 daysOncology
TAFLINAR6 fills of 15 daysOncology
TARCEVA6 fills of 15 daysOncology
TARGRETIN (bexarotene)6 fills of 15 daysOncology
TASIGNA6 fills of 14 daysOncology
TECHNIVIE6 fills of 14 daysHepatitis C
VERZENIO6 fills of 14 daysOncology
VICTRELIS6 fills of 15 daysHepatitis C
VIEKIRA PAK6 fills of 14 daysHepatitis C
VIEKIRA XR6 fills of 14 daysHepatitis C
VOSEVI6 fills of 15 daysHepatitis C
VOTRIENT6 fills of 15 daysOncology
XALKORI6 fills of 15 daysOncology
XENAZINE (tetrabenazine)6 fills of 15 daysHuntington’s Chorea
XTANDI6 fills of 15 daysOncology
ZELBORAF6 fills of 15 daysOncology
ZEPATIER6 fills of 14 daysHepatitis C
ZOLINZA6 fills of 15 daysOncology
ZYKADIA6 fills of 15 daysOncology
ZYTIGA6 fills of 15 daysOncology