Specialty Pharmacy and Specialty Infusion Programs

Specialty Pharmacy Program

Tufts Health Plan continuously works to offer its members the most clinically appropriate and cost-effective services.

As a result, Tufts Health Plan has designated specialty pharmacies to supply a select number of medications used in the treatment of complex diseases. These pharmacies are specialized in providing these medications and are staffed with nurses, coordinators and pharmacists to provide support services for members. Medications include, but are not limited to, those used in the treatment of infertility, multiple sclerosis, Hepatitis C and growth hormone deficiency, rheumatoid arthritis, and cancers treated with oral medications. Other designated specialty pharmacies and medications may be identified and added to this program from time to time.

Specialty Infusion Program

The Specialty Infusion (SI) Program offers clinical management of drug therapies, nursing support and care coordination to members with acute and chronic conditions. Tufts Health Plan has designated specialty infusion providers for a select number of specialized pharmacy products and drug administration services. Place of service may be in the home or alternate infusion site based on availability of infusion centers and determination of the most clinically appropriate site for treatment. These medications are covered under the medical benefit (not the pharmacy benefit) and generally require support services, medication dose management and special handling in addition to the drug administration services. Medications include, but are not limited to, medications used in treatment in hemophillia pulmonary hypertension, and immune deficiency. Drugs in the Specialty Infusion Program are listed throughout the formulary with (SI), indicating the Specialty Infusion Program. Other specialty infusion providers and medications may be identified and added to this program from time to time.