Step Therapy Drug Classes Step Therapy Drug Classes (cont)

Drug Class Drug Class PPI’S Enhanced (heartburn and ulcer) Leukotriene (allergies/asthma) 1st Line Drugs 1st Line Drugs Omeprazole, Lansoprazole Fluticasone propionate, Beconase AQ, Flonase, 2nd Line Drugs Flunisolide, Nasacort, Nasarel, Veramyst, Na - Nexium, Prevacid, Aciphex, Dexilant sonex, Rhinocort AQ, Omnaris, Fexofenadine, Prilosec, Protonix, Zegeid Allegra, Allegra-D, Clarinex, Clarinex-D, Claritin, HEALTH CARE CHAPTER Claritin-D, Zyrtec, Zyrtec D, Xyzal, Astelin/Astepro, Patanase Drug Class BENEFIT FUND HMG’s (high cholesterol) 2nd Line Drugs Accolate, Singulair, Zyflo 1st Line Drugs Lovastatin, Pravastatin, Simvastatin Drug Class 2nd Line Drugs Lyrica (neuropathic pain) Crestor, Vytorin, Lipitor, Altoprev, Caduet, Lescol, Lescol XL, Livalo, 1st Line Drugs Mevacor, Pravachol, Zocar Gabapentin 2nd Line Drugs Drug Class Lyrica Angiotensin ll Receptor Antagonists-A2s (high blood pressure) Drug Class 1st Line Drugs Topical Immunomodulators (skin disorders) Benazepril, Benazepril/HCTZ, Captopril, 1st Line Drugs Captopril/HCTZ, Enalapril, Enalapril/HCTZ, Alclometasone, Amcinonide, Betamethasone Fosinopril, Fosinopril/HCTZ, Lisinopril, dipropionate (augmented), Betamethasone Lisinopril/HCTZ, Ramipril, Quinapril, dipropionate, Clobetasol, Clobetasone, Quinapril/HCTZ, Moexipril, Trandolapril, Fluocinonide Moexipril/HCTZ, Benazepril/Amlodipine, 2nd Line Drugs Perindopril, Trandolapril/Verapamil, Elidel, Protopic Enalapril/felodipine, Losartan, Losartan/HCTZ 2nd Line Drugs Atacand HCT, Atacand, Avalide, Avapro, Azor, Step Therapy is a program especially designed Benicar, Benicar HCT, Cozaar, Diovan HCT, for people who take prescription drugs regularly Diovan, Exforge, Exforge HCT, Hyzaar, Micardis, to treat ongoing medical condition(s). The Micardis HCT, Teveten, Teveten HCT, Twynsta program is a new approach to getting you and your family the prescription drugs you need, at a Drug Class COX II’s (pain/inflammation) more affordable cost to you and the Fund. 1st Line Drugs The world of prescription medications can be Diclofenac, Etodolac, Fenoprofen, Flurbiprofen, Ibuprofen, Indomethacin, Ketoprofen, confusing. We’re constantly bombarded with television ads promoting the benefits of brand- Ketorolac, Meclofenamate, Mefenamic acid, th Meloxicam, Nabumetone, Naproxen, Oxaprozin, 52 Broadway, 12 Floor name medications. And, for some conditions, Piroxicam, Sulindac, Tolmetin New York, NY 10004 there are dozens of alternatives from which to 2nd Line Drugs 212) 982-5547 choose. How do you know what’s best? Celebrex Fax (212) 510-6430 Step Therapy can help you sort it out. The Step Therapy Program is a program which press Scripts – the company chosen to manage our tion drug regularly or if you’re a new member of our applies to first-time users of drugs in the following pharmacy benefit plan – they review the most current plan. If this occurs and you need your medication categories: research on thousands of drugs tested and approved quickly, you can: Talk with your pharmacist about by the FDA for safety and effectiveness. Then they filling a small supply PPI’s Enhanced (heartburn and ulcer) recommend appropriate prescription drugs for a Step • Talk with your pharmacist about filling a HMG’s-CO-A Inhibitors (cholesterol) Therapy program, and our organization’s prescription small supply of your prescription right away. Angiotensin ll Receptor Antagonists-A2s benefit plan chooses the drugs that will be covered. You may have to pay full price for this drug. (high blood pressure) Then, ask your doctor to write you a new COX II’s (pain/inflammation) What Happens at the Pharmacy? prescription for a first-step drug, so you’re Leukotriene (allergies/asthma) sure your medication will be covered by our Lyrica (neuropathic pain) Why couldn’t I fill my plan. Remember: Only your doctor can Topical Immunomodulators (skin disorders) prescription at the pharmacy? approve and change your prescription to a first-step drug. In Step Therapy, the covered drugs you take are The first time you submit a prescription that isn’t for organized in a series of “steps,” with your doctor a first-step drug, your pharmacist will tell you there’s approving and writing your prescriptions. a note on the computer system indicating that our To Receive a Second-Step Drug plan uses Step Therapy. This simply means that if • The program usually starts with “generic you’d rather not pay full price for your prescription drugs in the “first step.” Rigorously I’ve already tried the drug, your doctor needs to give you a prescription for tested and approved by the U.S. Food & Drug a first-step drug. first-step drugs on the list. Administration (FDA), the generics covered What can I do? by our plan have been proven to be effective To receive a first-step drug: in treating many medical conditions. This • Ask your pharmacist to call your With Step Therapy, more expensive brand-name first step allows you to begin or continue doctor and request a new prescription, drugs are usually covered in a later step in the treatment with safe, effective prescription or program if: drugs that are also affordable: Your co-pay - • Contact your doctor to get a new 1) you’ve already tried the generic drugs ment is usually the lowest with a first-step pr escription. drug. covered in our “first Step Therapy program”, Only your doctor can change your current prescrip - 2) you can’t take them (for instance, because “brand-name drugs are • More expensive tion to a first-step drug covered by your program. of an allergy), or usually covered in the “second step,” even though the generics covered by our 3) your doctor decides you need a brand- plan have been proven to be effective in How do I know what “first-step” name drug, for medical reasons. treating many medical conditions. drug my doctor should prescribe? If one of these applies to you, your doctor can ask for a “prior authorization” for you to take a second-step Your doctor is consulted , approving and writing You can call Express Scripts at the number on the prescription drug. Once the prior authorization is your prescriptions based on the list of Step Therapy back of your prescription card. An agent can give you approved, you pay the appropriate co-payment for drugs covered by our plan. For instance, your some examples of possible prescription drugs for you this drug. If the prior authorization is not approved, doctor must write your new prescription when you to discuss with your doctor. Also, enclosed with this you may need to pay the full price for the drug. change from a first-step drug to a second-step one. letter is a list of examples which you can take with you to the doctor. For more information on how Step Therapy works Who decides what drugs are and how it benefits you, watch this short video at: covered in Step Therapy? I need a prescription filled http://www.steptherapyfacts.com immediately. What can I do? If you or your doctor have further questions you can Step Therapy is developed under the guidance and call Express Scripts at 1-800-467-2006 open 24 hours direction of independent, licensed doctors, pharma - At the pharmacy, you may be informed that your drug a day, seven days a week. Or you can go to cists and other medical experts. Together with Ex - isn’t covered if you’ve just started taking a prescrip - www.express-scripts.com.