Moving preferred to non-preferred

Non-Preferred
DO Preferred
Brands ($$$)
Alternatives ($ or $$) *
Preferred Drug List
Dear Member:
Please review this Preferred Drug List (PDL) with Formulary Disclaimer:
your physician at the time he or she writes your Please be sure your prescription drug benefit is offered prescription. This PDL, which includes both brand through RxEDO before consulting this list. Coverage for and generic medications, is not a complete list, some drugs may be limited to specific dosage forms but a summary of the most commonly prescribed and/or strengths. Your benefit design determines what is medications. Your plan’s benefit design covered for you and what your co-payment will be. determines which medications are included or Please refer to your benefit materials for specific excluded from coverage. Please refer to your coverage information. The medications listed on this benefit information for applicable copays and formulary are subject to change pursuant to the of a medication on this formulary does not guarantee that you as a plan member will be prescribed that drug by your primary care physician or contracting provider for a particular medical condition. These medications may be Dear Physician:
subject to Prior Authorization. As new generics become Please refer to this list when prescribing for your available the corresponding brand name drug will no patient. The medications listed and all generic equivalents are Preferred Drug Choices under the patient’s prescription benefit. The PDL is not intended as a substitute for your professional Preferred Drugs for your patients, out-of-pocket expense and plan costs may be lowered. When applicable, generic prescribing is optimal. As generic equivalents become available in the *Please note that the preferred alternatives listed here are not a complete listing of all alternatives, only those You can access this list via our member portal at medications that are most commonly prescribed. 09/01/08
Growth Hormones
Oral Anti-Diabetic Agents
Anti-Inflammatory
Heart Disease/Blood
Pressure
CNS-Stimulants
Atypical Antipsychotics
Antibiotics
Contraceptives
Osteoporosis Agents
Blood Glucose Diagnostics
Cholesterol Reduction
Ophthalmics
Anti-Migraine Agents
CNS-Anxiety
Anti-Virals
Estrogens
Overactive Bladder
Antidepressants
CNS-Nausea
Prostate Agents
Asthma/COPD
CNS-Parkinson’s
Sleep Aids
Gastrointestinal
Topical Preparations
CNS-Seizures
Anti-Fungals
Multiple Sclerosis Agents
$ - Generic drugs (listed in all lowercase letters) have the lowest copay
$$ - Preferred brand name drugs (listed in all CAPITAL letters) have the middle copay
$$$ - Non-preferred brand name drugs (listed in all CAPITAL letters on the front of this handout) have the highest copay
Drug Formulary Update
Dear Member,
Effective September 1, 2008, your Preferred Drug List will be updated to include the following
preferred brand drug deletion. The list below details the drug that will be moving from preferred
status to non-preferred status due to the availability of a generic.

Drugs moving to Non-Preferred with Generic Available (generic equivalent)

RxEDO’s Pharmacy & Therapeutics (P&T) Committee continually evaluates all drugs available in the market. Updates are based on those drugs that produce the best medical outcomes for our members. Please review and discuss these changes with your physician. Should you have any questions please contact our member services department toll free at (888) 879-7336. Thanks! The RxEDO Member Services Team ReThinking, ReEvaluating, ReDefining…Prescription Benefits

Source: http://busdbenefits.com/assets/pdf/RxEDO_select(090108).pdf