Pharmacy Initiatives

To help control costs and reduce your out-of-pocket expenses for prescription drugs, we'll implement the following programs, effective Sept. 4, 2007:

Member Education Therapeutic Interchange

This program educates members about generic drugs and over-the-counter equivalents of expensive brand-name medications.

• Download a list of drugs included in the Member Education Therapeutic Interchange Program (PDF)

Dose Optimization

This program encourages the use of select prescription drugs in once-daily dosage regimens when appropriate, which is less expensive than the higher cost multiple daily doses.

• Download a list of drugs included in Dose Optimization Program (PDF)

Brand-to-Alternate Generic Interchange

This program encourages the interchange of brand-name drugs with less costly generic alternatives.

• Download a list of drugs included in the Brand-to-Alternate Generic Interchange Program (PDF)

Generic Copay Waiver

This program offers a one-month copay waiver when members switch to the generic equivalent of a specifically targeted drug.

• Download a sample list of drugs included in the Generic Copay Waiver Program (PDF)

Brand-to-Brand Therapeutic Interchange

This program promotes the exchange of targeted high-cost brand-name drugs to lower cost brand-name drugs in the same therapeutic class.

• Download a list of drugs included in the Brand-to-Brand Therapeutic Interchange Program (PDF)

Quantity Limit

This program restricts the dispensing of targeted drugs in quantities not consistent with the FDA-approved labeling for the drugs.

• Download a list of drugs included in the Quantity Limit program (PDF)

Exclude Off-Label Coverage

This program disallows coverage for drugs prescribed for uses other than those approved by the FDA.

• Download the Off-Label Program drug list (PDF)

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Questions? We can help!

If you are not sure whether your BCBSM benefits include these programs, please contact customer service.