A comprehensive, cost-effective pharmacy plan that can reduce premiums now, protect against rising costs in the future and align copays to costs. Your costs go down and you're offering employees a quality pharmacy plan with access to effective, affordable drugs.
Why this option now?
- The costs of specialty drugs - those used to treat complex conditions like cancer, rheumatoid arthritis, Crohn's disease, cystic fibrosis, multiple sclerosis and transplants - already cost $10,000-$50,000 per individual per year.
- As the pharmaceutical industry continues to discover new ways to treat complex diseases, the number of these high-cost drugs on the market will also increase.
- Specialty drugs are expected to grow from 1% of all drugs dispensed today to up to 5% within the next 5 years.
- It's a proactive way of providing cost protection for you, starting today and into the future, with minimal impact on members.
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3-Tier with Specialty Drug Management advantages
3-Tier with Specialty Drug Management features
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3-Tier Pharmacy with Specialty Drug Management advantages
- Members pay less for generics and more for non-preferred specialty drugs, and you lower your overall prescription plan costs.
- Variety of pharmacy copay/coinsurance options for small and large groups
- Prior authorization and step therapy requirements removed on more than 100 commonly used medications so they're easier for your employees to obtain
- Solid prescription coverage and significant prescription discounts for your employees
- Pharmacy case management services promote safety, effectiveness and cost-savings
3-Tier Pharmacy with Specialty Drug Management features
- Five tiers - 3 for standard drugs and 2 for specialty drugs:
- Generic - FDA-approved prescription drugs that contain the same active ingredients as the brand-name equivalents; produced and distributed without a patent
- Preferred brand-name - Commonly prescribed brand-name drugs that are well-established as safe and effective
- Non-preferred brand-name - High-cost drugs that can usually be replaced by a lower-cost alternative with equal or better clinical effectiveness
- Preferred specialty - Specialty drugs that are clinically and cost effective
- Non-preferred specialty - High-cost specialty drugs that can usually be replaced by a lower cost alternative with equal or better clinical value
- Add this plan to a Priority Health HMO, PPO, POS, HSA or HealthbyChoice IncentivesSM plan
- Network of more than 60,000 Michigan pharmacies, numerous national chains and nationally-known mail order service
Find out more
- Using the Approved Drug List - Shows your employees how they can check to see if their prescriptions are covered
- Transition fills - If an employee is taking a drug that's not on our Approved Drug List, they may qualify for a transition fill
Contact the Priority Health employer representative for your region or your independent agent for more information about 3-Tier Pharmacy with Specialty Drug Management.
Last modified
12/11/09
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