Optima Health announces daily dosage restrictions for antidepressants
With the safety of our members in mind, we regularly review Food and Drug Administration (FDA) alerts with both our Pharmacy and Therapeutics Committee and Psychiatry Advisory Committee. Both committees have advised Optima Health to implement maximum daily dosage limits for certain classes of drugs as recommended by FDA.
As a result, effective Oct. 1, new claims for daily doses of antidepressants above these amounts will be rejected at the pharmacy. Because we recognize that there may be rare exceptions necessitating the use of higher than recommended dosages of medications, we will review dosing exception requests on a case-by-case basis via the Medical Necessity Request Form found on the Optima Health website.
For members currently on higher dosages of antidepressants, Optima Health will not interrupt therapy. However, for these members, any further dosage increase will require submission of medical necessity information for review.
As a commitment to our members’ safety, evidence-based recommendations, as well as manufacturer-reported dosing limits, will continue to be reviewed prior to implementation of each therapeutic class.
Contact Optima Health Member Services at the number on the back of your member ID card if you have any questions regarding your benefits.
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