Venlafaxine ER

We understand that any change in the cost of your prescription medications can be concerning. That is why we want to provide you with information about why your medication is being excluded from benefit coverage and advise you of your options.

In order to provide affordable medication choices, we may need to exclude a more expensive medication, that works the same as other, lower cost prescription medications. Before we exclude a medication from benefit coverage, we review all of the medications used to treat that particular illness or condition. If two or more medications are considered equivalent, meaning they treat a condition the same way, and one medication does not provide any clinical value over the other, we look at the cost of the medications to determine overall tier placement and possible benefit exclusion.

Venlafaxine ER is used to treat depression and was launched in October 2008. The “ER” means extended release, so the medication slowly releases into the body over several hours. Venlafaxine ER contains the same active ingredient as Effexor XR, but in tablet form versus capsule form, which was enough of a difference for the Food and Drug Administration (FDA) to grant approval. The manufacturer of Venlafaxine ER launched their product using the generic name as the brand name. Venlafaxine is the generic name for Effexor, which adds to the confusion. The class overview below details all forms of Effexor and Venlafaxine.

This Venlafaxine ER exclusion is in response to the now common pharmaceutical strategy in which new drugs are introduced that often add no clinical value over lower cost alternatives. Individuals are moved to the more costly drug with the impression that it is newer and better, when in reality, the original drug offers the same treatment outcomes at a much lower cost. With Venlafaxine ER, there is the added strategy of using the generic name as the brand name, which makes individuals mistakenly think they are getting a generic at a good value. UnitedHealthcare addresses these pharmaceutical strategies in ways that will reduce your employer's costs while maintaining many affordable options for you.

Generic Effexor, venlafaxine HCL, (non extended release form) is a great value and is available in Tier 1, so this is the most affordable option. If you want the exact medication as Venlafaxine ER in capsule form, Effexor XR is available in Tier 2, which is actually a lower cost than what you are paying now.

 

Medication	Generic Name	Dosage form	Tier Placement/Benefit Coverage
Effexor (brand)	Venlafaxine HCL	Tablet	Tier 3
Effexor XR (brand)	Venlafaxine HCL, extended-release	Capsule	Tier 2
venlafaxine HCI (generic Effexor)	Venlafaxine HCL	Tablet	Tier 1
Venlafaxine ER (brand)	Venlafaxine HCL, extended release	Tablet	Excluded

 

We realize everyone reacts differently to medications and one may work better for you than another, which is why you will need to contact your doctor to see what is right for you. Decisions about which medications you take remain between you and your doctor. We simply want to provide the information you need to make an informed decision and help lower your costs.

 

Keep in mind that the benefit plan documents provided by your employer or health plan may include a Summary Plan Description or a Certificate of Coverage, and a Pharmacy Rider. These documents define your pharmacy coverage and may exclude coverage for certain medications. If you do not have the benefit plan documents, please contact your employer or health plan for this information.

May not apply to members in Texas.