The term “specialty drug” applies to:

• Self-administered injectable medications (non-diabetes)
• Medications that require special handling, special administration, or monitoring, and
• High-cost oral medications.

Covered specialty drugs are listed on the University of Michigan Prescription Drug Plan Formulary. Specialty drugs are those products on the drug plan formulary that are marked with an "S," "SCN," or "LDD" symbol. The list includes select medications used to treat a variety of clinical conditions and is subject to change.

Filling a Specialty Drug Prescription

Contact U-M Specialty Pharmacy Services when you have received a prescription for a specialty medication.

• Michigan Medicine Specialty Pharmacy will arrange specialty prescription drug and supply delivery directly to a patient’s Michigan address.
• Members may walk in and pick up their specialty medication prescriptions from select pharmacy locations during normal business hours. 
• Michigan Medicine Specialty Pharmacy may make arrangements for additional handling for prescriptions outside the state of Michigan or where manufacturers limit distribution to certain pharmacies (i.e., a "limited distribution drug").

Important Notes

Enrollment Required

Please note that you must be enrolled with the Michigan Medicine Specialty Pharmacy before your physician can call, fax, or electronically prescribe a new specialty medication prescription. Members may enroll by calling the Michigan Medicine Specialty Pharmacy at the number below.

Supply Limits

Specialty drugs are limited to 34 days per fill, except for generic immunosuppressive drugs and drugs to treat HIV, which are covered for up to 90 days per fill.

Exceptions

Limited distribution drugs (LDD) are specialty drugs that are required to be filled at select external specialty pharmacies. Each LDD product has a unique list of specialty pharmacies. Please contact the  U-M Specialty Pharmacy for more information.

Members Living out of Michigan Medicine Service Area

The U-M Specialty Pharmacy is able to ship medications to members in the states of Michigan, Arizona, Florida and Colorado. If you require shipment outside these service areas, the plan allows fills at Magellan Rx/Prime Therapeutics Specialty Pharmacy and Birdi Mail Order Pharmacy. If needed, an override for an outside specialty pharmacy could also be requested. Contact Magellan Rx/Prime Therapeutics at (888) 272-1346 if assistance is needed.

U-M Specialty Pharmacy Services Contact Information

Michigan Medicine
University of Michigan Specialty Pharmacy Services
7300 W Joy Road
Dexter, MI 48130

Hours:
9 a.m. – 5 p.m., Monday – Friday
Closed on weekends and major holidays

(855) 276-3002 (toll free)
(866) 261-0791 (toll free) – if using TTY
(734) 232-3408 fax

Michigan Medicine Specialty Pharmacy 

Additional Locations:

Taubman Center Pharmacy
1500 East Medical Center Drive
Ann Arbor, MI 48109

Hours:
9 a.m. - 6 p.m., Monday – Friday
8:30 a.m. – 4:30 p.m., Saturday

(734) 936-8260

Cancer Center Pharmacy
1500 East Medical Center Drive
Ann Arbor, MI 48109

Hours:
9 a.m. - 5:30 p.m., Monday – Friday

(734) 647-8911

Frequently Asked Questions About Specialty Drugs

Which types of drugs are included in the specialty drug program?

The U-M prescription drug plan formulary covers several categories of drugs, including oral and self-injectable cancer drugs; anticoagulant, hematopoietic, and immunosuppressive drugs; growth hormones; drugs for rheumatoid arthritis, psoriasis, cystic fibrosis, hepatitis, multiple sclerosis, and pulmonary hypertension; some infertility medications; and other oral and self-injectable (non-diabetes) drugs for varying conditions.

Do specialty drugs require prior authorization?

Any specialty medications that require prior authorization (PA) are noted on the drug plan formulary next to the drug name. Your physician must call Magellan Rx/Prime Therapeutics at (888) 272-1346 to obtain prior authorization on your behalf when required.

How much specialty drug medication can I get filled each time?

Specialty drugs are limited to 34 days per fill, except for immunosuppressive drugs and drugs to treat HIV, which are covered for up to 90 days per fill. You can check the drug plan formulary for specific information on supply limits for your medication. Plan participants using a telecommunications device for the deaf (TTY) may dial 711.

Where can my specialty drug prescription be filled?

Contact the U-M Specialty Pharmacy when you get a prescription for a specialty drug. Specialty medications may be shipped directly to a patient’s U.S. address with no shipping fees, or members can walk-in and pick up their specialty medication prescriptions at the pharmacy.  Exceptions include some infertility medications and/or specialty drugs that are restricted by the manufacturer to be filled at certain pharmacies (“limited distribution drugs”). Please see the drug plan formulary for more information.

Why does the U-M Specialty Pharmacy have to handle my specialty drug prescription?

Specialty drugs represent less than 2% of all medications used by our plan members, but more than 45% of the total plan cost.  The average cost for specialty drugs is over $4,500 per month per prescription, and growing. Using a designated specialty pharmacy helps the plan better support members and manage costs. The U-M Specialty Pharmacy receives special price discounts that can help the university keep health care costs affordable.

What if my physician is not associated with Michigan Medicine?

Your physician does not need to be located at a Michigan Medicine facility for you to use Specialty Pharmacy, and you do not need to change your physician to receive your specialty medications. Specialty Pharmacy will provide specialty medication services to members regardless of where your physician is located.

What patient services does U-M Specialty Pharmacy provide?

U-M Specialty Pharmacy will handle the filling of your specialty drug prescription either in person or by mail with no shipping costs (for U.S. addresses). They also provide a range of programs and patient support services, including:

• Pharmacist telephone support
• Coordination of refills to help manage medication schedules
• Financial counseling and support (e.g. copay discount cards, PA approvals)
• Clinical support for improved disease state and drug therapy management for complex health conditions.

How will the U-M Specialty Pharmacy use my personal information?

Please be assured that your privacy is protected. If your current physician is outside of Michigan Medicine, your personal information is stored in the pharmacy only, and is not part of the hospital patient record system. Your protected health information will not be shared with anyone outside your physician’s office without your permission.

Disclaimer

Please be advised that the University of Michigan Prescription Drug Plan formulary is updated periodically and changes may appear prior to their effective date to allow for client notification. The University of Michigan does not warrant or assure accuracy of such information nor is it intended to be comprehensive in nature. The medical provider should consult the drug manufacturer's product literature or standard references for more detailed information. Every effort is made to ensure complete and accurate information; however, the most accurate source of medication coverage and member cost the Magellan Rx/Prime Therapeutics online pricing tool. The pricing tool will not provide cost estimates for the product selection penalty or medications that require prior authorization.