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Nov. 14, 2008

UPMC Health Plan formulary changes for 2009

Through UPMC’s partnership with UPMC Health Plan, keeping employee copayments for prescription drugs as low as possible is a priority that we look to achieve through the active management of our pharmacy benefit. The primary goal in this process is to ensure the health and safety of all Health Plan members, by creating a high-quality and affordable pharmacy formulary that takes advantage of effective alternatives to expensive prescriptions as they become available, and helps members to steer clear of medications that are not medically necessary or not superior to other medications.

How does UPMC Health Plan decide what drugs are on the formulary?

A committee, made up of hospital and community pharmacists, community physicians, and members of the UPMC Health Plan, provides input to determine what medications should be covered on the formulary.

The following are some of the formulary updates that will occur for Jan. 1, 2009.

• Omeprazole OTC will be covered in place of Prilosec OTC. This allows UPMC employees to take advantage of the new availability of a generic version of Prilosec OTC.

• Protonix will be removed from the formulary. Formulary alternatives available include omeprazole OTC, Prevacid, and Nexium.

• Oxycontin will move from a preferred brand to a non-preferred brand. In addition, this medication will require a prior authorization, which means your doctor must consult with UPMC Health Plan before prescribing it.

• Welchol will move from a non-preferred brand to a preferred brand.

How can you learn more?

To find out more about generic drugs, review which drugs are covered under the pharmacy benefit, arrange for your prescriptions to be delivered to your home, or locate a pharmacy near you, access the Open Enrollment section of Infonet or log on to MyHealth Online through My HUB, click on the Human Resources tab, then click on MyHealth/MyFlex Advantage under My Benefits.

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