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Provider updates

A “Concerta’d” Effort to Remove Age Limits

Aug 3, 2022, 22:55 PM

Update on methylphenidate ER. At our last P&T meeting we voted to remove the age restriction from generic Concerta. Previously for members aged 19 and over, a prior authorization was required. No PA will be required now. However, there is some nuance to this. Only the AB rated generic of Concerta is covered (methylphenidate HCl tab ER osmotic release). This is the version than can be substituted by the pharmacist if the Dr. writes for Concerta. There is a different version that is NOT AB rated (methylphenidate HCl tab ER 24hr). This one can’t be automatically substituted by the pharmacist. The non-AB rated version is non-formulary. There is still a quantity limit on the formulary product. 

In short:

  1. The AB-rated generic of Concerta (methylphenidate HCl tab ER osmotic release) does not require PA. There is a quantity limit of 1 tablet per day.
  2. The non-AB-rated “generic” of Concerta (methylphenidate HCl tab ER 24hr) is no longer on formulary.