Microsoft word - step therapy p90 custom exhibit 03 4 13
North Scott Community School District 04/01/2013: Changes to your MedTrak Prescription Benefit Plan Introducing the Performance 90 Network The Performance 90 Network is Network of thousands of pharmacies where you will be able to fill your 90-day supplies of medications. As your prescription benefits manager, MedTrak proactively looks for ways to enhance your prescription drug benefit. As a result, we are introducing the MedTrak Performance 90 (P90) Pharmacy Network designed to deliver convenience and savings for Members who would like to fill 90-day prescriptions.* Lower Rates – MedTrak has negotiated the lowest possible rates with P90 pharmacies on 90-day supplies of maintenance medications, which equals Member and Plan savings.
Convenience – The P90 Network offers a variety of pharmacies, such as grocery stores, national
chains, independents and big box retailers providing convenience to our Members.
Extensive Pharmacy Selection – Over 31,000 retail pharmacies are integrated into the P90
Network, offering our Members an extensive pharmacy selection.
*Please note that filling your 90-day medications at a Performance 90 Pharmacy will be optional. If you
currently use the Mail Order service and you wish to continue to use the Mail Order service, you will not
be required to change pharmacies.
Step Therapy Program
Step Therapy is a program that assists in managing the increasing costs of prescription drugs and will
help save you money on your medications. Effective April 1, 2013, the North Scott Schools plan will
implement Step Therapy.
To Whom Does the Program Apply?
Step Therapy will apply to anyone who is prescribed a drug for the first time in one of 15 therapeutic
classes targeted by the program. If you are currently taking a drug in one of these classes, your
prescription will not be affected. See Page 3 for a listing of current drug classes in the Step Therapy
Program.
If there is a reason you are not able to take the Step One drug, please have your doctor's office
contact MedTrak Services 1.800.771.4648
How Does it Work?
If you receive a prescription for the first time and the drug is included in the Step Therapy program, your
plan will cover the cost of a lower-cost drug initially (Step One drugs), but not the higher cost alternative
(Step Two drugs). Step One drugs have been clinically proven to be safe and effective in treating your
North Scott Community School District condition. In addition, they are more affordable, providing savings for both you and your plan.
If you currently take a Step Two medication, there will be no change to your benefit. HOWEVER, if you
are prescribed a Step Two medication after April 1st, 2013, Step Therapy guidelines will be followed and
your prescription must be changed to a Step One drug.
What Should You Do?
1. If you receive a new prescription after April 1st, tell your physician that your plan has a Step Therapy program. Physicians are familiar with this and they should be able to prescribe you the appropriate Step One drug. 2. To check and see if your newly prescribed drug is considered a Step Two drug prior to going to the pharmacy, please contact MedTrak at 1.800.771.4648. Checking in advance will eliminate delay at the pharmacy. 3. If you attempt to fill a prescription for a Step Two drug at the pharmacy, the pharmacist will be notified by MedTrak via electronic messaging that the drug is part of a Step Therapy Program along with Step One therapeutic alternatives. In most cases the pharmacist is willing to contact your physician directly. If they are unwilling or unable, to do so, you should contact your physician and/or MedTrak for further assistance. Again, this can be avoided by contacting MedTrak at 1.800.771.4648 prior to going to the pharmacy.
IMPORTANT NOTE: This process occurs only the first time you fill a new prescription
that is covered by the Step Therapy Program.
Questions?
If you have questions about the Step Therapy Program or the Performance 90 Network, please contact a
MedTrak Pharmacy Benefit Advisor at 1.800.771.4648.
North Scott Community School District Step Therapy Drug Classes Do you take
If You Take Any One of These
You Will Need to Switch to One of these Step-One
medications for the
Step-Two Medications:
Medications and Get 6 Months Free!
following conditions?
Atacand/HCT Edarbyclor Blood Pressure
Micardis/HCT Irbesartan (Avapro) ARBs and ARB
esartan/HCT (Avalide) Blood Pressure
Blood Pressure
Nisoldipine (Sular) Channel Blockers
High Cholesterol
Crestor 5mg,10mg,20mg Fluvastatin (Lescol) Depression
Escitalopram (Lexapro) Depression
Venlafaxine ER Tabs Venlafaxine ER Caps Acid Reflux
Dexilant Omeprazole/Na Bicarb Lansoprazole (Prevacid) ( Fluticasone (generic Flonase) Triamcinolone (generic Hay Fever
Flunisolide (generic Nasarel) Nasal Steriod Inhalers
Carisoprodol 350mg Carisoprodol 250mg Metaxalone (Skelaxin) Chlorzoxazone 500mg Muscle Spasms
Actonel Fosamax Sol. Ibandronate Tabs (Boniva) Atelvia Skelid Fosamax D Enablex Overactive Bladder
Gelnique Gel 10% Oxytrol Patch Axert Migraines
Prostate Health
Doxycycline Mono Tab & Minocycline HCL Tabs Doxycycline Hyc Cap (generic for Minocycline HCL Cap (generic for Minocin) Doxycycline Hyc Tab & Cap Minocycline HCL Cap 75 Doxycycline Hyc Cap (generic for Doxycycline Mono Cap 75 Doxycycline Hyc Tab (generic for Minocycline HCL Tab SR Doxycycline Mono Cap (generic Insomnia
Methylphenidate/CR/ER Narcolepsy
Methylin Chewable Note: This list is not all inclusive and is subject to change. Generic listed with (brand) indicated, both available as Step 2.
Source: https://www.north-scott.k12.ia.us/pdf/staff/StepTherapyP90CustomExhibit.pdf
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