The Medicare GLP-1 Bridge program is active effective today. This 18-month program covers GLP-1 drugs with a $50 copay for eligible patients’ Medicare Part D plan. Here are some important things to consider as the program gets underway.
Remember that:
1. Total reimbursement to the pharmacy for the GLP-1 drug NDCs in the program is WAC + $3 within 14 days.
2. The Bridge has an open network, and pharmacies can submit claims via a payer sheet.
3. There is a prior authorization process to ensure appropriate utilization.
You can find the payer sheet here. CMS has more details on the Medicare GLP-1 Bridge on its website and has created an eligibility wizard. NCPA members can also watch the webinar NCPA hosted with CMS experts here. We also have links to prescriber and pharmacy fact sheets, as well as the prior authorization form, here.
If you need help with your NCPA member login, chat with us online or email membership@ncpa.org.
