Pharmacy benefit changes

In order to keep the pharmacy benefit affordable for members and provide access to high quality, effective medication options, several changes to the pharmacy benefit will be implemented beginning May 1.

Migraine Medicine Copay Changes
Triptans are medications used to treat certain migraine and cluster headache conditions. Beginning May 1, 2009, the copay for triptans, Amerge®, Axert®, Frova®, Zomig®, and Zomig ZMT®, will be $50, for up to a 34-day supply (Note: All triptans are subject to quantity limits).

Coverage Review for Migraine Medications
Also beginning May 1, 2009, all users of Amerge®, Axert®, Frova®, Treximet®, Zomig®, and Zomig ZMT® will be subject to a formulary coverage review. (Note: All triptans are subject to quantity limits). Coverage will only be granted if your provider documents that you have experienced failure or intolerance with a preferred migraine medication (Sumatriptan, Maxalt, Maxalt MLT or Relpax).

Antiemetic (Anti-nausea Medication) Quantity Limits
Antiemetics are medications used to prevent and treat chemotherapy-induced nausea and vomiting. Beginning May 1, 2009, prescriptions for antiemetics (Anzemet®, Emend®, Kytril®(granisetron), Granisol®, Zofran®(ondansetron), Cesamet®, and Sancuso®) will have quantity limits.

Click here for more information and for frequently asked questions (FAQs), or call Medco Customer Service at 1-800-336-5933 for more information.

Filed under: