Medication Therapy Management Program

TML Intergovernmental Employee Benefits Pool

NEW Prescription Benefits!

RESTAT is the new vendor that will manage the network of pharmacies

RX Results-University of Arkansas College of Medical Services– peforms clinical evaluation, call center and physician outreach

Medication Therapy Management Program expands the value tier to enhance access to the $0.00 and $9.00 generic program.

Wal-Mart Sam’s Dominick’s Target HEB Fred Meyer Kroger Safeway HealthMart Pharmacy Randall’s K-Mart King Soopers Tom Thumb City Market Pharmacy Ralph’s Cub Pharmacy Dillon Stores Smiths Farm Fresh Fry’s Food & Drug Vons Companies Inc. Access Health Quality Food Centers Inc Shopko

Start Market

Restat’s Align Network New Pharmacies are being added each month

Medication Therapy Management Program (MTMP)

$

$$

$$$

Lowest Cost

Highest Cost

Mac A or C Employer Option RetailCopay Mail Order Copay

Over the Counter Equivalence:Non-Sedating Antihistamines (Claritin, Alavert) Stomach and Ulcer (Prilosec) Allergy Medication (Zyrtec)Smoking Cessation (Nicorette Gum) Limit - 3 boxes

$0.00 N/A

Value Tiered 34 day generic dispensement

$0.00 N/A

Value Tiered 84-90 day generic dispensement

$9.00 N/A

Generic $10.00 $25.00Best Brand Price List $38.00 $95.00Non-Best Brand Price List $60.00 $150.00

Cost Share $120.00

$300.00

Specialty/Biotech Prescriptions $100.00 for 34 day

dispensement

8 ways to Purchase Prescription Drugs

CVS Caremark will continue to administer mail order / Biotech.

Cost Share DrugsEvidence Based Drug Formulary

Cost Share Drugs Therapeutic Equivalent / Clinical Drug AlternativeAntibiotics: Anti-InfectionsImpacts utilization on: Doryx, Solodyn, Oracea

Generic Minocycline (for Solodyn)Generic Doxycycline (for Doryx, Oracea)

Cardiovascular: AntihyperlipidemicImpacts utilization on: Altoprev, Advicor, Crestor 5 mg & 10mg, Lescol, Lescol XL, Lipitor 10mg, Lipitor 20mg, Lipitor 40 mg, Lovastatin, Mevacor, Pravachol, Pravastatin, Simcor, Zocor, Caduet and Vytorin

Generic SimvastatinNOTE: Lipitor 80mg, Crestor 20mg, and Crestor 40mg require prior authorization – Physician may call Rx Results at 1-888-871-4002 for coverage criteria.

Central Nervous System: Sedative HypnoticsImpacts utilization on: Ambien, Ambien CR, Lunesta, Rozerem, Sonata and Zaleplon

Generic Zolpidem

Gastrointestinal/Stomach: Proton Pump InhibitorsImpacts utilization on: Aciphex, Dexilant (formerly Kapidex), Nexium, Lansoprazole, Pantoprazole, Prevacid, Prilosec, Protonix and Zegerid

OTC Prilosec (Prescription Required) Generic Omeprazole

Respiratory/Allergy/Asthma: AntihistaminesImpacts utilization on: Allegra, Fexofenadine, Clarinex and Xyzal

OTC Claritin (Prescription Required) Generic Loratidine (Prescription Required) OTC Zyrtec (Prescription Required)OTC Cetirizine (Prescription Required)

Anithistamines-DecongestantImpacts utilizaqtion on: Allegra-D, Fexofenadine-D and Clarinex-D

OTC Claritin (Prescription Required) Generic Loratidine (Prescription Required) OTC Zyrtec (Prescription Required)Generic Cetirizine (Prescription Required)

Cost Share Generic Drugs

Relative Potency for Statins

Atorvastatin(Lipitor)

Fluvastatin(Lescol / XL)

Lovastatin(Mevacor)

Pravastatin(Pravachol)

Rosuvastatin(Crestor)

Simvastatin(Zocor)

-- 40 mg 20 mg 20 mg -- 10 mg

10 mg 80 mg 40 or 80 mg 40 mg -- 20 mg

20 mg -- 80 mg 80 mg 5 or 10 mg 40 mg

40 mg -- -- -- -- 80 mg

80 mg -- -- -- 20 mg --

-- -- -- -- 40 mg --

Medication Therapy Management Program (MTMP)Clinically Appropriate & Cost Effective Prescriptions

Prior Authorization: Growth Hormones- Botox, Myobloc Attention Deficit Disorder/Narcolepsy- medications for individual 17 years of age or olderOral Chemotherapy•Antibiotic- Zyvox •High Cholesterol- Crestor 20/40 mg , Lipitor 80 mg •Osteoporosis- Forteo •Testosterone Products- Androgel-Hormone Replacement/Erectile Dysfunction•Asthma- Xolair, Advair and Symbicort (inhalers), Foradil, Perforomist, Brovana, Serevent, - individuals <40 years of age that have not utilized an inhaled steroid for at least 120 days

Step Therapy: •Asthma- Advair and Symbicort (inhalers), Foradil, Perforomist, Brovana, Serevent, - individuals <40 years of age that have not utilized an inhaled steroid for at least 120 days•***High Blood Pressure: Cozaar, Hyzaar, Diovan, Diovan HCT, Atacand, Atacand-HCT, Avapro, Avalide, Micardis, Micardis HCT, Teveten, Teveten HCT, Benicar, Benicar HCT, Exforge, Tekturna, Tekturna HCT and Valturna (***only applies to newly diagnosed individuals***)

Concurrent Review:Hepatitus C prescriptions

Current Prior Authorizations will need to be re-established

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Is Evidence Based Medicine.

Converts Patients from costly drugs to therapeutically equivalent, cost effective alternatives.

Ask your Dr. to contact Rx Results, (the number is on your ID Card)

Look up drug prices at www.restat.com

Medication Therapy Mangement Program:

Thank You.