Harvard Pilgrim Health Care has put a “split fill” policy in place for certain oral oncology drugs, also known as oral chemotherapy.1

Oral oncology drugs can cause difficult side effects. Doctors may need to prescribe different doses or strengths until their patients can tolerate the medication better.

Finding the right dose for oral oncology drugs is a process that can take a few months. Dispensing a full month’s supply during the time when patients may need to try different strengths can be expensive and potentially waste medication.

Harvard Pilgrim’s split fill program helps save money and avoid drug waste with partial fills for certain oral oncology prescriptions. Here’s how it works:

  • A member receives a prescription to start a new oral oncology drug
  • The pharmacy fills part of the prescription instead of a full month’s supply
  • The member continues to receive partial amounts of their prescription for three months. The cost-sharing amount the member pays is adjusted based on the partial amount of medication dispensed.2
  • Starting with the fourth month, the pharmacy dispenses a full month’s supply of the oral oncology drug, and the member pays their regular prescription drug cost-sharing amount

The split fill program applies to select oral oncology drugs, which were evaluated using evidence-based criteria. Members who have questions can call Member Services at the number on their ID card.

Footnote(s)
1

The split fill program does not apply if you have your coverage through an employer who offers it on a self-insured basis or if you have a Medicare plan.

2

Prescription drug cost-sharing amounts are based on the member’s pharmacy benefits.