1. Describe the clinical programs and member education (including nurse/pharmacist access) that you offer related to specialty products that help manage appropriate use and product selection. 2. Please provide detailed information on the people, process, and information sources used to develop your prior authorization (“PA”) criteria for specialty drugs along with samples of the servicing documents your PA department uses for making a decision to approve a drug. What percentage of all PA's were approved in 2023? 3. Define all the disease states where you have a formal clinical program. Describe the clinical protocols your organization uses to manage appropriate and cost-effective utilization of specialty medications. • Asthma • Crohn’s Disease • Cystic Fibrosis • Growth Hormone Deficiency • Psoriasis • Hemophilia • Oncology including oral • Hepatitis • Rheumatoid Arthritis • Multiple Sclerosis • HIV • Ulcerative Colitis 4. Please describe in detail the Utilization Management programs that your PBM has to offer the Client. In reference to Utilization Management programs, here, we are specifically referring to Prior Authorization rules, Step Therapy rules, and rules to manage Quantity Level Limits. Please respond considering the framework that follows
