The Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid
100 Hancock Street, 6th Floor Quincy, Massachusetts 02171

CHARLES D. BAKER
Governor

KARYN E. POLITO
Lieutenant Governor

MARYLOU SUDDERS
Secretary

www.mass.gov/eohhs

DANIEL TSAI
Assistant Secretary

Subject: Preferred buprenorphine/naloxone product
January 2016

Key Points:
•	Suboxone Film™ will be the preferred buprenorphine/naloxone product
•	All other formulations will require prior authorization for all doses and durations
•	Current prescriptions and prior authorizations will be grandfathered for the life of the prescription or prior authorization
•	Updated prior authorization requirements will be fully effective on February 8, 2016

Dear Prescriber,

Effective February 8, 2016, MassHealth will be implementing Suboxone Film™ as its preferred buprenorphine/naloxone product. To avoid disrupting therapy, MassHealth will not require a new prior authorization for members with a current prior authorization on file for another buprenorphine/naloxone product until the current prior authorization has expired. Members without a prior authorization on file, who have a prescription with refills for another buprenorphine/naloxone product, will be allowed to obtain the refills of that product remaining on the prescription.

Once prior authorization or refills are expired, members will be required to use Suboxone Film™, unless another formulation is medically necessary and prior authorization has been granted. The MassHealth Drug List, including Therapeutic Class Table 36 outlining the coverage status and PA criteria for buprenorphine/naloxone, will be updated to reflect these changes. The MassHealth Drug List can be found on the MassHealth Pharmacy website at www.mass.gov/masshealth/pharmacy.

Ensuring access to buprenorphine/naloxone treatment is a priority for the Pharmacy Program. We appreciate your continued support and dedication to providing high quality care to MassHealth members.

Sincerely,

Paul L. Jeffrey, PharmD Director of Pharmacy MassHealth