PHARMACY BENEFIT
Updates Since Your Last Issue
Dean Health Plan (DHP) has a
Web-based PDF document that
lists all the formulary medications
and their corresponding tier level.
This list is at www.deancare.com.
Click on “Dean Health Plan,” then
“Members,” then “Pharmacy
Information,” then “Drug
Formulary.” You can search
the document easily by clicking
the binocular icon on your toolbar.
The pharmacy information Website
has two additional lists that may
be viewed online: the Drug Prior-
Authorization List, which includes
drugs restricted to certain specialists,
and the Drug Exclusion List.
You can also call Customer Service
at Drug Prior-Authorization List
The medications on this list require prior authorization (PA) by DHP. Brand names are listed first, with the generic name in parentheses.Removed From PA List
Tamiflu (oseltamivir)As drugs are approved by the U.S. Food and Drug Administration (FDA), we may add them to this list. Your physician or your pharmacist should fill out a Drug Prior- Authorization Request Form. For urgent authorizations, your physician should call Customer Service.
Drugs Restricted to Certain Specialists (RS)
The following drugs are covered only when prescribed by the following specific specialties. Submission of prior authorization is not required for the specialties indicated. These drugs are not available for all other specialties. Brand names are listed first, with the generic name in parentheses.Added to RS List
Avastin (bevacizumab): oncology or retinal cliniciansEmend (aprepitant): oncology or anesthesiology clinicians
Lucentis (ranibizumab): retinal clinicians
Tysabri (natalizumab): neurology clinicians
Removed From RS List
Forteo (teriparatide injection)General exclusions: nonprescription over-thecounter
drugs, weight-loss products, drugs
for cosmetic use and oral medications for the
treatment of sexual dysfunction
Please note: Some members may have coverage
for some of these drugs based on their
individual pharmacy benefit or an authorization
from DHP.
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