There Are More Affordable Options Available

There are a few medications moving to a higher tier on the Prescription Drug List. That means that members taking these medications may pay a higher cost share. These medications often cost more than other available medications that treat the same condition. We try to make lower-cost options available to you in order to keep health care costs down for everyone. You can continue to take your current medication, though you may pay a higher cost share. Look at the chart below to find your medication and lower-cost options in the same therapeutic class. Talk to your doctor to see if one of the lower-cost medications is right for your treatment. Refer to your benefit plan documents to determine if a particular drug is covered under your benefit plan.

Medications moving to a higher tier on July 1, 2010:

Aciphex® — Ulcers, Heartburn, and Reflux (Proton Pump Inhibitors – PPIs)

Current Tier: 2
New Tier: 3

Alternatives:
omeprazole, Prevacid® 24HR, Prilosec OTC®, Zegerid OTC™

Rationale:
There are several over-the-counter (OTC) options available including Prilosec OTC, Prevacid 24HR, and Zegerid OTC. Aciphex costs about seven times more than omeprazole.


Dipentum® — Inflammatory Bowel Disease (IBD)

Current Tier: 2
New Tier: 3

Alternatives:
Apriso®, Lialda®, sulfasalazine (generic Azulfidine®)

Rationale:
Dipentum is priced at a premium to covered alternatives.


Protonix® — Ulcers, Heartburn, and Reflux (Proton Pump Inhibitors – PPIs)

Current Tier: 2
New Tier: 3

Alternatives:
omeprazole, Prevacid® 24HR, Prilosec OTC®, Zegerid OTC™

Rationale:
There are several over-the-counter (OTC) options available including Prilosec OTC, Prevacid 24HR, and Zegerid OTC. Protonix costs about seven times more than omeprazole.


Tazorac® cream and gel — Acne / Psoriasis

Current Tier: 2
New Tier: 3

Alternatives*:
Retin-A-Micro®, tretinoin cream and gel

Rationale:
Tazorac is available in both a cream and gel formulation. Tazorac is about three times more expensive than clinically similar tretinoin. There are also several OTC options available.


Vytorin® — High Cholesterol

Current Tier: 2
New Tier: 3

Alternatives:
Crestor®, Lipitor®, simvastatin (generic Zocor®)

These alternatives may be eligible for the Half Tablet Program.

Rationale:
Vytorin is made up of of ezetimibe (commonly known as Zetia) and simvastatin (generic Zocor). As a combination product, Vytorin is priced at a premium compared to other cholesterol lowering medications.


Zegerid® — Ulcers, Heartburn, and Reflux (Proton Pump Inhibitors – PPIs)

Current Tier: 2
New Tier: 3

Alternatives:
omeprazole, Prevacid® 24HR, Prilosec OTC®, Zegerid OTC™

Rationale:
There are several over-the-counter (OTC) options available including Prilosec OTC, Prevacid 24HR, and Zegerid OTC. Zegerid costs about seven times more than omeprazole.




*If you are taking this medication for psoriasis talk to your physician about potential alternatives.