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Asthma Xolair Factor Products Advate Alphanate Alphanine Autoplex Bebulin Benefix Feiba Helixate FS Hemofil H

Specialty Pharmacy Program Medical Benefit Drugs*. Therapeutic Class Drug. Therapeutic Class Drug. Asthma Xolair Factor Products Advate Alphanate Alphanine Autoplex Bebulin Benefix Feiba Helixate FS Hemofil Humate Koate Kogenate Konyne Monarc Monoclate Mononine

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Asthma Xolair Factor Products Advate Alphanate Alphanine Autoplex Bebulin Benefix Feiba Helixate FS Hemofil H

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  1. Specialty Pharmacy ProgramMedical Benefit Drugs* Therapeutic Class Drug Therapeutic Class Drug Asthma Xolair Factor Products Advate Alphanate Alphanine Autoplex Bebulin Benefix Feiba Helixate FS Hemofil Humate Koate Kogenate Konyne Monarc Monoclate Mononine NovoSeven Profilnine Proplex Recombinate Refacto Gaucher's Cerezyme PPH Flolan Remodulin Psoriasis Amevive Rheumatoid Arthritis Remicade RSV Synagis Drugs Under Both Benefits Therapeutic Class Drug Anemia/neutropenia Aranesp Epogen Neulasta Neupogen Procrit *examples only – not a comprehensive list

  2. Specialty Pharmacy ProgramPharmacy Benefit Drugs* Therapeutic Class Drug Therapeutic Class Drug Therapeutic Class Drug Therapeutic Class Drug Growth Hormone Genotropin Humatrope Increlex Norditropin Nutropin Saizen Serostim Tev-Tropin Zorbtive Hepatitis C Copegus Infergen Intron A Pegasys Peg-Intron Rebetol Rebetron Ribavirin Multiple Sclerosis Avonex Betaseron Copaxone Rebif Rheumatoid Arthritis Enbrel Humira Kineret Psoriasis Raptiva Enbrel Drugs Under Both Benefits Therapeutic Class Drug Anemia/neutropenia Aranesp Epogen Neulasta Neupogen Procrit *examples only – not a comprehensive list

  3. Members are directed to the specialty pharmacy that provides their specific medications at a low net cost The Specialty Pharmacy Referral Line directs members to the appropriate specialty pharmacy • Toll-free telephone number 866-429-8177 • 24 hours a day/365 days a year • Trained customer service representatives (CSRs) answer questions and explain the process • CSRs are fully trained on the program and protocols for directing members to the right pharmacy

  4. Quality Assurance is an integral part of the network strategy As of January 1, 2007, implemented nationally for more than 4.9 million members

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