2011 Prescription Drug Changes With UHC

Changes to drugs on the tier schedule have been set for January 1, 2011. Please click here to view the UHC summary of all drugs moving up a tier, down a tier, or placed as a new exclusions, etc. Please review this list for any prescriptions you may take. Changes to tier structure can make an impact on your flex spending election for the new year.

2011 Select Designated Pharmacy Program

This new program through UHC targets a select number of high-cost drugs while still providing affordable choices. This program offers members three cost-savings options. First switch to mail order pharmacy and keep current medication. Second, switch to a lower-tier medication and keep getting at your local pharmacy. Third, switch to lower-tier medication and go through mail order pharmacy and save even more money. The following targeted medication and products are affected by this program.

Anticonvulsant/Nerve Pain – Lyrica
Asthma/COPD – Symbicort
Benign Prostatic Hyperplasia (BPH) – Avodart, Uroxatral
Depression – Lexapro
Diabetes: Glucose Testing Strips – Ascensia, Breeze, Contour, Freestyle Glucometer, Precision
Diabetes: Insulins – Novolog, Novolog Mix, Novolin N, Novolin R, Novolin mix
High Blood Pressure – Atacand, Atacand HCT, Avapro, Avalide
Inflammatory Bowel Disease – Asocol, Asacol HD
Migraine Headaches – Axert, Frova, Maxalt, Maxalt MLT, Zomig, Zomig ZMT
Overactive Bladder – Toviaz, Detrol

Click here to see a listing of lower tier alternatives to these prescriptions. If you don’t switch to one of the three options, you will then be required to pay the full cost of the drug at the pharmacy and submit a request for reimbursement to UHC. Manual reimbursements for prescriptions will be reimbursed less the tier 3 copay, less the typical discounts given directly at the pharmacy which will mean less reimbursement to you the employee.

9/1/09 United Health Care Drug Changes

United Health Care prescription drug list changes effective 9/1/09 main changes are as follows:

Rescue Inhalers (short-acting beta agonists):
Ventolin HFA moving down to tier 1
Xopenex HFA moving up to tier 3UHC also implementing new supply limit on all inhalers effective 9/1.

Oral Contraceptives:
Ocella moving up to tier 3
Yasmim moving down to tier 2

Adherence Incentive Program (Depression):
Effective 10-1-09
New capability that if members refill their prescription within a defined time period, they will receive a $20 member discount off their copayment. Program will include three medications in the depression therapeutic class: Cymbalta, Effexor XR and Pristiq.
Effexor XR moving up to tier 3

Please read attached document from United Health for all rationale and reasoning behind all pending changes.

City Prescription Drug Consultant meetings

Call now for a confidential One-On-One Meeting with Terry Maves , R.Ph. UHC Pharmacy Director.