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. You can find this
list at our website. 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 Added to PA List
Tarceva (erlotinib)
Zegerid (omeprazole)
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
Ranexa (ranolazine): cardiology
Drug Exclusion List
Our drug benefit does not automatically cover every new drug that the FDA approves. We have a panel of physicians from various specialties to evaluate new drugs. If an excluded drug has been prescribed for you, ask your physician or pharmacist whether he or she can substitute it with one of the medications that we cover. Brand names are listed first, with the generic name in parentheses.Added
Iplex (mecasemin)
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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