New Pharmacy Prior Authorization Program
The North Carolina State Health Plan will implement a new prior authorization program for certain medications used to treat insomnia January 2, 2007. The medications Ambien®, Ambien CR™, Sonata®, Lunesta™ and Rozerem™ will require prior approval for a total quantity in excess of 15 tablets or capsules in a 34-day period. This quantity is based on guidelines that are approved by the Food and Drug Administration for uses considered reasonable, safe and effective. A member’s physician may request prior approval by calling Medco toll free at 1-800-417-1764, Monday through Friday, 8 a.m. to 9 p.m. EST.
Insomnia is a condition characterized by the inability to get a good night’s sleep. It affects the amount and quality of sleep. Most individuals experience short-term insomnia lasting between a few days to about three weeks. For short-term insomnia, 7-10 nights of medication use is often sufficient, and treatment longer than three weeks is generally not needed. Individuals who experience insomnia lasting for months or years should be evaluated by a physician.
State Health Plan members* can visit www.shpnc.org, log in to the Personal Health Portal and search the word ‘sleep’ for resources related to sleep.
For more additional information on sleep-related topics, visit:
*State Health Plan members whose primary health insurance is through the State Health Plan, and who are not on COBRA.
