CHANGES TO YOUR DRUG LIST

Transcription

1 CHANGES TO YOUR DRUG LIST More generics and lower-cost brands to help you stay healthy and save money At Cigna, it s our goal to offer you access to coverage for safe, effective and affordable medications. To do this, we regularly review and update our drug list. Starting July 1, 2017,* some of the medications on the Standard Prescription Drug List will change coverage (or cost) levels. These changes affect how much you pay for your medications. Medications where you may pay more Starting July 1, 2017, the medications listed below will be non-preferred on your plan s drug list. Non-preferred means this medication may cost you more than similar medications. If you fill a prescription for any of these medications on or after this date, you may pay more at the pharmacy. We ve also listed some lower-cost generic and/or preferred brand alternatives to talk about with your doctor. NON-PREFERRED BRAND MEDICATION INFECTIONS Daklinza + Epclusa +, Harvoni +, Sovaldi + + This is a specialty medication. Specialty medications are used to treat complex or chronic conditions like multiple sclerosis, hepatitis C and rheumatoid arthritis. Some plans cover specialty medications on a specialty tier. For plans with a specialty tier, this change will not affect the cost of your medication. To find out how your plan covers these medications, please check your enrollment materials or log into mycigna.com. Medications not covered on your drug list^ Starting July 1, 2017, the medications listed below will not be covered on your plan s drug list.^ If you fill a prescription for any of these medications on or after this date, you ll have to pay the full cost of the medication. We ve also listed some lower-cost generic and/or preferred brand alternatives to talk about with your doctor. BLOOD PRESSURE/HEART MEDICATIONS Cardizem diltiazem Isordil Titradose Lanoxin isosorbide dinitrate CHOLESTEROL MEDICATIONS Antara, Fenoglide fenofibrate digitek, digox, digoxin COUGH/COLD MEDICATIONS Tussicaps hydrocodone-chlorpheniramne ER, promethazine-codeine DIURETICS Edecrin, ethacrynic acid bumetanide, furosemide, torsemide GASTROINTESTINAL/HEARTBURN Anusol-HC suppository anucort-hc, hemmorex-hc, hydrocortisone, procto-med HC, proctosol-hc, proctozone-hc Omeclamox-pak, Prevpac, Pylera lansoprazole-amoxicillin-clarithromycin (combo pak) a Standard 04/17

2 HORMONAL AGENTS Dexpak dexamethasone INFECTIONS Onmel itraconazole, terbinafine PAIN RELIEF AND INFLAMMATORY DISEASE Conzip tramadol, tramadol ER levorphanol acetaminophen-codeine, hydrocodoneacetaminophen, hydromorphone ER, hydromorphone, lorcet, lorcet HD, lorcet plus, oxycodone, oxycodone ER, tramadol, verdrocet, Vicodin, Vicodin ES, Vicodin HP Naprelan, naproxen CR, naproxen ER, Zipsor diclofenac, diclofenac ER, etodolac, etodolac ER, fenoprofen, flurbiprofen, ibuprofen, indomethacin, ketoprofen, ketorolac, meclofenamate, mefenamic acid, meloxicam, nabumetone, naproxen Zomig ZMT zolmitriptan ODT SKIN CONDITIONS Aldara imiquimod Anusol-HC cream Clobex Ertaczo, Extina, Vusion Halog Locoid lipocream Loprox Oxistat Penlac Plexion Prudoxin, Zonalon Salex trianex Ultravate anucort-hc, hemmorex-hc, hydrocortisone, hydrocortisone acetate, procto-med HC, proctosol-hc, proctozone-hc clobetasol, clodan shampoo ketoconazole clobetasol propionate, halobetasol propionate hydrocortisone butyrate ciclodan, ciclopirox Clotrimazole, econazole nitrate, ketoconazole, oxiconazole nitrate Ciclodan, ciclopirox sulfacetamide-sulfur, SS 10-2, Zencia doxepin salicylic acid triamcinolone, triderm Ala-cort, alclometasone dipropionate, aminonide, apexicon, betamethasone dipropinate, betamethasone valerate, clobetasol emollient, clobetaslon emulsion, clobetasol propionate, clocortonlone pivalate, clodan, cormax, desonide, desoximetasone, diflorasone diacetate, fluocinolene acetonide, fluocinonide, fluocinonide-e, flurandrenolide, fluticasone propionate, halobetasol propionate, hydrocortisone, hydrocortisone butyrate, hydrocortisone valerate, micort-hc, mometasone furoate, prednicarbate, psorcon, scalacort, tacrolimus, triamcinolone acetonide, trianex, triderm

3 Medications that need approval for coverage SKIN CONDITIONS (cont) Ultravate X clobetasol propionate, halobetasol propionate Verdeso desonide SLEEP DISORDERS/SEDATIVES Ambien zolpidem Ambien CR zolpidem ER ^ These medications aren t covered on your drug list. Your prescription drug plan requires approval from Cigna for these medications to be covered. If your doctor feels that an alternative medication isn t right for you, he or she can ask Cigna to consider approving coverage of your medication. Starting July 1, 2017, the medications listed below will require approval from Cigna before they re covered under your plan. MISCELLANEOUS PAIN RELIEF AND INFLAMMATORY DISEASE MEDICATION REQUIRING PRIOR AUTHORIZATION Syprine acetaminophen-codeine, ascomp with codeine, aspirin-caffeine-dihydrocodeine, belladonna-opium, butalbital-acetaminophen caffeine-codeine, butalbitalcaffeine-acetaminophen codeine, butalbital compoundcodeine, butorphanol, carisoprodol compound-codeine, carisoprodol-aspirin-codeine, codeine, Demerol, dihydrocodeine-acetaminophen-caffeine, Dilaudid, Duragesic, Embeda, Endocet, Exalgo, fentanyl patch, Fioricet with Codeine, Hycet, hydrocodoneacetaminophen, hydrocodone ibuprofen, hydromorphone, hydromorphone ER, Hysingla ER, Ibudone, Kadian ER, levorphanol tartrate, Lorcet, Lorcet HD, Lorcet Plus, Lortab, meperidine, morphine sulfate, morphine sulfate ER, MS Contin, norco, Nucynta, Nucynta ER, Opana, Opana ER, Oxaydo, oxycodone acetaminophen, oxycodoneaspirin, oxycodone-ibuprofen, oxycodone, oxycodone ER, oxymorphone ER, oxymorphone, Oxycontin, pentazocinenaloxone, Percocet, Primlev, Reprexain, Roxicodone, Synalgos-DC, trezix, Tylenol-codeine, Verdrocet, Vicodin, Vicodin ES, Vicodin HP, Xartemis XR, Xodol, Xtampza ER, Xylon 10, Zamicet, Zohydro ER Cuprimine, Depen Titratab ADDITIONAL INFORMATION Ask your doctor to call us. Your plan will only cover this medication if your doctor requests and receives approval from Cigna. MEDICATION WITH QUANTITY LIMITS ADDITIONAL INFORMATION COUGH/COLD MEDICATIONS GASTROINTESTINAL/HEARTBURN MISCELLANEOUS Flowtuss, hycofenix, Hydrocod-cpm-pseudoephedrine, Hydrocodone BT-homatropine, Hydrocodonechlorpheniramne ER, Hydrocodone-homatropine, hydromet, obredon, Promethazine VC-codeine, Promethazine-codeine, Promethazine-phenyleph-codeine, Rezira, Tussicaps, Tussigon, Tussionex, Tuzistra XR, Vituz, Zutripro Opium Tincture Evzio, Naltrexone Your plan only covers a certain amount of this medication. If your doctor writes a prescription for an amount more than what s allowed, it will only be covered in that amount if your doctor requests and receives approval from Cigna.

4 MEDICATION WITH QUANTITY LIMITS ADDITIONAL INFORMATION PAIN RELIEF AND INFLAMMATORY DISEASE Abstral, acetaminophen-codeine, actiq, alfentanil, ascomp with codeine, aspirin-caffeine-dihydocodeine, belladonnaopium, butalbital-acetaminophen-caffeine-codeine, butalbital-caffeine-acetaminophen-codeine, butalbital compound-codeine, butalbital-acetaminophen-caffeine, butalbital-aspirin-caffeine, butorphanol, capacet, carisoprodol compound-codeine, carisoprodol-aspirincodeine, codeine, Demerol, dihydrocodeine-acetaminophencaffeine, Dilaudid, duramorph, Endocet, esgic, fentanyl patch, fentanyl-bupivacacaine, fentora, fioricet, fioricet with codeine, fiorinal, finorinal with codeine, hycet, hydrocodoneacetaminophen, hydrocodone-ibuprofen, hydromorphone, Ibudone, infumorph, ionsys, lazanda, levorphanol, Lorcet, Lorcet HD, Lorcet Plus, Lortab, meperidine, morphine, nalbuphine, norco, Nucynta, Nucynta ER, Opana, Oxaydo, oxycodone, oxycodone-aspirin, oxycodone-ibuprofen, oxycodone-acetaminophen, oxymorphone, pentazocinenaloxone, Percocet, Primlev, Reprexain, Roxicodone, subsys, sufentanil, Synalgos- DC, talwin, trezix, Tylenol-codeine, ultiva, Verdrocet, Vicodin, Vicodin ES, Vicodin HP, Xodol , xodol 5-300, xodol , Xylon 10, zamicet, zebutal Fentora Your plan only covers a certain amount of this medication. If your doctor writes a prescription for an amount more than what s allowed, it will only be covered in that amount if your doctor requests and receives approval from Cigna. Narcotic pain medications (opioids) As opioid-related deaths continue to increase in the U.S.,** we want to make sure you re using these medications safely and effectively. Because of this, we re making changes to the coverage of opioids (narcotic pain medications). Depending on your plan, if you fill a prescription for an opioid for the first time, it may need approval for coverage and/or you may be limited in the amount of medication you can fill at one time. What you should do next Talk with your doctor. Switching to a generic or preferred brand alternative may help save you money. You should ask your doctor if one of these medications may be right for you. Review your coverage on mycigna.com. Starting July 1, 2017, log into mycigna.com to view your plan s drug list and/or use the Drug Cost tool to see how these changes may affect the cost of your medication. If you have questions We know how important your pharmacy benefits are and we re here to help. Please call us at the toll-free number on the back of your Cigna ID card.

5 * In accordance with Texas and Louisiana state law, customers with affected benefit plans who receive coverage for medications that are removed from the prescription drug list during the plan year will continue to have those medications covered at the same benefit level until their plan renewal date. To find out if these state mandates apply to your plan, please call Customer Service. ** American Society of Addiction Medicine, Opioid Addiction: 2016 Facts & Figures, Para obtener ayuda en español llame al número en su tarjeta de Cigna. All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, and HMO or service company subsidiaries of Cigna Health Corporation, including Cigna HealthCare of Arizona, Inc., Cigna HealthCare of California, Inc., Cigna HealthCare of Colorado, Inc., Cigna HealthCare of Connecticut, Inc., Cigna HealthCare of Florida, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Indiana, Inc., Cigna HealthCare of St. Louis, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of New Jersey, Inc., Cigna HealthCare of South Carolina, Inc., Cigna HealthCare of Tennessee, Inc., and Cigna HealthCare of Texas, Inc. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc a Standard 04/ Cigna. Some content provided under license.