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. The 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 With 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.Added to PA List
Sprycel (dasatinib)
Removed From PA List
Byetta (exenatide)
Inspra (eplerenone)
Revatio (sildenafil)
Revised on PA list
Humira (adalimumab)
Provigil (modafanil) 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 drugs on this list are covered only when prescribed by the specific specialties. Submission of prior authorization is not required for the specialties indicated. These drugs are not available for all other specialties.Revised on RS List
Humira (adalimumab): gastroenterology (without prior authorization) or rheumatology for the treatment of rheumatoid arthritis, juvenile rheumatoid arthritis, psoriatic arthritis, reactive arthritis and ankylosing spondylitis
Drug Exclusion List
Our drug benefit does not automatically cover every new drug that the FDA approves. We have a panel of physicians from many different specialties to evaluate new drugs. If an excluded drug has been prescribed for you, ask your physician or pharmacist if he or she can substitute it with one of the medications we cover.General exclusions: nonprescription over-the-counter 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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