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CuraScript, Inc., Express Scripts Specialty Pharmacy, dispenses specialty medications to people with major medical conditions and provides other personalized services. Through CuraScript, patients receive highly technical care delivered in a personal manner to help them manage their health and get the most from Arestin Added to Specialty Drug List
OraPharma's Arestin® (minocycline hydrochloride) Microspheres, 1mg is a tetracycline
antibiotic approved for certain oral procedures in adult patients with periodontitis. It is supplied
as a dry powder in unit-dose cartridges and is administered by a healthcare professional.
Arestin is exclusively available through CVS/Caremark. More information can be found at:

Cuvposa Added to Specialty Drug List
Shionogi Pharma's Cuvposa™ (glycopyrrolate oral solution) 1mg/5mL was approved by the
U.S. Food and Drug Administration (FDA) in July 2010. It is an anticholinergic medication
indicated to reduce chronic drooling in patients 3-16 years of age with neurologic conditions
associated with problem drooling (e.g., cerebral palsy). It is only available through Diplomat
Specialty Pharmacy. Because this was identified as a limited distribution medication, it was
added to the specialty drug list.
Erwinaze Added to Specialty Drug List
On Nov. 18, 2011, Eusa Pharma received approval from the U.S. Food and Drug Administration
(FDA) for its orphan drug Erwinaze™ (asparaginase Erwinia chrysanthemi) for the treatment of
acute lymphoblastic leukemia (ALL) in patients with hypersensitivity to E.coli-derived
asparaginase. ALL is the most common childhood cancer with approximately 2,900 patients
younger than 20 years of age diagnosed each year in the United States. Between 15% and
20% of patients develop hypersensitivity to E.coli-derived asparaginase, preventing continued
treatment. Erwinaze is administered as an intramuscular injection. Eusa launched Erwinaze
upon approval.
Eylea Added to Specialty Drug List
On November 18, 2011, Regeneron received approval from the U.S. Food and Drug
Administration (FDA) for Eylea™ (aflibercept) Injection for the treatment of patients with
neovascular (wet) age-related macular degeneration (AMD). Eylea is a biologic drug known as
a vascular endothelial growth factor [(VEGF) or angiogenesis] inhibitor that works by blocking
the formation of new blood vessels in the back of the eye. Eylea is administered as injection
into the back of the eye by a healthcare professional. The recommended dose for Eylea is 2mg
once monthly for three months followed by 2mg every other month. Regeneron launched Eylea
shortly after approval. Eylea costs $1850 per injection. It is available through a limited number
of specialty pharmacies and distributors, including CuraScript Specialty Pharmacy and
Specialty Distribution.
Ferriprox Added to Specialty Drug List
On October 14, 2011, ApoPharma received accelerated approval from the U.S. Food and Drug
Administration (FDA) for Ferriprox® (deferiprone) to treat patients with iron overload due to
blood transfusion in patients with thalassemia who have had an inadequate response to prior
chelation therapy. Thalassemia is a genetic blood disorder in which the body makes an
abnormal form of hemoglobin (protein in red blood cells that carries oxygen), which results in
anemia. Patients with thalassemia require frequent blood transfusions to treat their anemia; however the blood transfusions can cause an excess build-up of iron in the body. Ferriprox is an oral chelator, which binds to and removes heavy metals (e.g., iron) from the body. The recommended dose of Ferriprox is 25mg/kg to 33mg/kg orally three times daily. It is supplied as 500mg film-coated scored tablets. Ferriprox is exclusively available through Centric. Nexplanon Added to Specialty Drug List
On Nov. 9, Merck announced the release of Nexplanon® in the United States. It is expected
that this new product will eventually replace Implanon™, a similar Merck product. Like
Implanon, Nexplanon is a long-acting, progestin-only, single-rod etonogestrel (68mg)
reversible hormonal implant contraceptive. Once properly placed, the implant is effective at
preventing pregnancy for up to three years, at which time it must be removed or replaced.
Upon removal, pregnancy can occur within as little as 7-14 days. Nexplanon differs from
Implanon in that it is a radiopaque implant that can be detected by palpation, two-dimensional
X-ray, computed tomography (CT scan), ultrasound scanning (USS), or magnetic resonance
imaging (MRI). Implanon can only be detected by palpation, USS or MRI. Nexplanon is
available through a limited number of specialty pharmacies including CuraScript.
Pricing
Claims will be processed according to your existing drug coverage rules. If you have questions
regarding the drug-list changes, pricing for the added drug or would like to alter your drug
coverage rules, please contact your Express Scripts Account Management team.
Definition of a Specialty Drug:
Specialty drugs are injectable and non-injectable drugs defined as having one or more of
several key characteristics, including:
 Requirement for frequent dosing adjustments and intensive clinical monitoring to decrease the potential for drug toxicity and increase the probability for beneficial treatment outcomes.  Need for intensive patient training and compliance assistance to facilitate therapeutic  Limited or exclusive product availability and distribution.  Specialized product handling and/or administration requirements.  Cost in excess of $500 for a 30-day supply. This information is intended for Express Scripts clients. Do not forward or provide this
information to other parties without permission from Express Scripts.
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Source: http://hr.eku.edu/sites/hr.eku.edu/files/files/Express_Scripts_Specialty_Drug_Updates_Jan_2012.pdf