Microsoft word - step-generics first 100113

Generics First - A Step Therapy Program
effective 10/1/13
Do you know that the Food and Drug Administration (FDA) requires generic drugs to have the same strength and purity as brand-name drugs? Generic drugs can be just as effective as their brand-name counterparts at a fraction of the price, so why would you spend more than you have to on your prescription medications? Choose generics and save. Your prescription drug plan is designed to save you money. Before you use one of the brand-name drugs listed here, you will first need to try a similar, alternative medication. In most cases, this will be a generic drug. Generics are approved by the FDA as safe and effective but will cost you less. Example: Before you can fill a new prescription for the brand-name drug Cymbalta, you will need to try one of the generic alternatives first – bupropion, fluoxetine, paroxetine, sertraline or venlafaxine. It’s important that you share this list with your doctor to help coordinate your medication needs. This list shows you which brand-name drugs are affected, as well as the recommended alternatives. This list represents prescription drugs in our standard Generics First - Step Therapy Program. Your benefits may be different. If you have any questions about this list, call the Customer Service number on the back of your BlueCross BlueShield of Tennessee member ID card. Before you take one
You must have tried
Before you take one
You must have tried
of these drugs…
ONE of these…
of these drugs…
ONE of these…
ACE INHIBITORS
ANGIOTENSIN II RECEPTOR BLOCKERS
ACE INHIBITORS WITH CALCIUM CHANNEL
BLOCKERS
ANGIOTENSIN COMBINATION DRUGS
ACE INHIBITORS WITH DIURETICS
Accuretic benazepril/hydrochlorothiazide Vaseretic lisinopril/hydrochlorothiazide Zestoretic moexipril/hydrochlorothiazide ANGIOTENSIN II RECEPTOR BLOCKERS WITH
DIURETICS
This list is subject to change throughout the year. Please call Member Service at the phone number listed on your BlueCross BlueShield of Tennessee member ID  card or visit our website at bcbst.com for the most up‐to‐date information.  Generics First - A Step Therapy Program
effective 7/1/13
Before you take one
You must have tried
of these drugs…
ONE of these…
ANTIDEPRESSANTS
Drug Benefit Appeals
You or your physician may appeal the denial of a drug benefit or a quantity limit by faxing supportive documentation to 1-888-343-4232. Please read your Evidence of Coverage for more information. Pexeva mirtazapine Pristiq paroxetine Prozac (all) BETA BLOCKERS
Betapace (all) acebutolol
Bystolic atenolol
Corgard carvedilol Kerlone labetalol Levatol metoprolol Lopressor nadolol Sectral pindolol Tenormin propranolol CALCIUM CHANNEL BLOCKERS
Adalat (all)
Cardizem (all) nicardipine Norvasc nifedipine LIPID LOWERING AGENTS (HMG Co-A Reductase
Inhibitors)

Advicor atorvastatin
Altoprev fenofibrate
Caduet fluvastatin
Crestor lovastatin
Lescol pravastatin
Lescol XL
Lipitor Liptruzet Mevacor Pravachol Vytorin Zocor PROTON PUMP INHIBITORS (PPIs)
Nexium cimetidine
Prevacid (all)
Prilosec lansoprazole Protonix nizatidine omeprazole pantoprazole ranitidine This list is subject to change throughout the year. Please call Member Service at the phone number listed on your BlueCross BlueShield of Tennessee member ID  card or visit our website at bcbst.com for the most up‐to‐date information. 

Source: http://www.cmcss.net/documents/benefits/GenericsFirst.pdf

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