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URx : Rethinking our Rx program: A New Strategic Approach

URx : Rethinking our Rx program: A New Strategic Approach. Clinical Monographs From PTAC (Pharmacy & Therapeutics Advisory Committee) Independent Committee consisting of the following : 3 Active Practice Physicians

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URx : Rethinking our Rx program: A New Strategic Approach

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  1. URx: Rethinking our Rx program: A New Strategic Approach

  2. Clinical Monographs From PTAC (Pharmacy & Therapeutics Advisory Committee) Independent Committee consisting of the following: 3 Active Practice Physicians 3 Active Practice Pharmacists 3 Consumers - Plan Members / Retirees / Union Reps Drug is tiered A,B,C,D, or F Efficacy evaluated first The Higher the Value, Cost evaluated second The Higher the Drug is tiered. Efficacy + Cost = Drug Value

  3. URx Benefit Design

  4. How Will URx Work For Me??? THE URx 4 STEP STEP 1 Review Your Medications – Know what they are……….. Complete Name Dosage – i.e. 10mg, 20mg. etc Frequency – i.e. Once daily, Twice daily, etc. STEP 2 Find out what tier your drugs received under the URx drug list.

  5. How Will URx Work For Me??? THE URx 4 STEP STEP 3 If they are D or F, you can find out about potential alternatives in classes A through C to discuss with your doctor. Call Ask-a-Pharmacistat 1-888-5-ASK-URX (527-5879) for assistance if needed. We will be mailing letters to members who have D and F drugs throughout the year to assist you with learning about your drugs and potential alternative drugs. STEP 4 If there are documented medical reasons why you cannot take one of the alternative drugs with a higher grade, URx Ask A Pharmacist staff can work with you to see if you are eligible to receive a better benefit for a lower grade drug. Have your PROVIDER complete and submit a Plan Exception Request form (available on-line, or call 1-888-527-5879).

  6. How do I find out my drug tier? • There are several ways to look up the tier of your drugs and potential alternatives: • Call general information at URx: 1-888-648-6764 • On the internet go to www.urxpharmacy.org

  7. For all MUST members your member ID # is a 9 digit number starting with 87and EXCLUDES the -01 behind your ID number. For example, use 871234567 to register. DO NOT include 871234567-01. Ex: 871234567

  8. Where do I go to fill my prescriptions ??? You can still use all of the same retail pharmacies. A new mail-order pharmacy called URx MedVantxwill also be available for you to use in addition to Ridgeway mail order. Diplomat Specialty Pharmacy is the URx provider for Specialty Drug Services. If you are currently in the specialty drug program, Diplomat will be in contact with you prior to July 1, 2013. S-$50 & S-$200 Specialty Medications

  9. Questions? General information on URx available at: 1- 888-648-6764n the internet go twww.urxpharmacy.org

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