Pharmacy Benefit Updates Since Your Last Issue

Dean Health Plan (DHP) has a Web-based PDF document that lists all of the formulary medications and their corresponding tier level. The list of DHP formulary drugs is at www.deancare.com. Once there, click on “Dean Health Plan,” then “For Members,” then “Pharmacy Information,” and finally “Drug Formulary.” The document is long, but you can search it 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 608-828-1301 or 800-279-1301 to request a complete copy of either list or for more information about your prescription drug benefit.

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

Prevacid^® (lansoprazole)

Removed from PA list

Lamisil^® (terbinafine)
Focalin^® (dexmethylphenidate)

Revised on PA list

Lyrica^® (pregabalin)
Protonix^® (pantoprazole)
Aciphex^® (rabeprazole)
Epogen^®, Procrit^® (epoetin alfa)

As drugs are approved by the U.S. Food and Drug Administration (FDA), we may add them to the above 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.

Removed from RS List

Topomax^® (topiramate)

Drug Exclusion List (DE)

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. Brand names are listed first with the generic name in parentheses.

Added to DE list

Zelnorm^® (tegaserod maleate)

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 one of these drugs based on an exception in their pharmacy benefit or an authorization from DHP.

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