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Microsoft word - rxedo_select_120107_.doc

Non-Preferred
EDO Preferred
Brands ($$$)
Alternatives ($ or $$) *
Preferred Drug List
Dear Member:
Please review this Preferred Drug List (PDL) with your physician at the time he or she writes your Formulary Disclaimer:
prescription. This PDL, which includes both brand Please be sure your prescription drug benefit is offered and generic medications, is not a complete list, through RxEDO before consulting this list. Coverage for some drugs may be limited to specific dosage forms but a summary of the most commonly prescribed and/or strengths. Your benefit design determines what is medications. Your plan’s benefit design covered for you and what your co-payment will be. determines which medications are included or Please refer to your benefit materials for specific excluded from coverage. Please refer to your coverage information. The medications listed on this benefit information for applicable copays and formulary are subject to change pursuant to the formulary management activities of RxEDO. The presence of a medication on this formulary does not guarantee that you as a plan member will be prescribed that drug by your primary care physician or contracting provider for a particular medical condition. These medications may be Dear Physician:
subject to Prior Authorization. As new generics become Please refer to this list when prescribing for your available the corresponding brand name drug will no patient. The medications listed and all generic equivalents are Preferred Drug Choices under the patient’s prescription benefit. The PDL is not intended as a substitute for your professional Preferred Drugs for your patients, out-of-pocket expense and plan costs may be lowered. When applicable, generic prescribing is optimal. As generic equivalents become available in the *Please note that the preferred alternatives listed here You can access this list via our member portal at are not a complete listing of all alternatives, only those medications that are most commonly prescribed. 12/01/07
Growth Hormones
Multiple Sclerosis Agents
Anti-Inflammatory
Heart Disease/Blood
Pressure
Oral Anti-Diabetic Agents
CNS-Stimulants
Atypical Antipsychotics
Antibiotics
Blood Glucose Diagnostics
Contraceptives
Osteoporosis Agents
Cholesterol Reduction
Ophthalmics
Anti-Migraine Agents
CNS-Anxiety
Anti-Virals
Estrogens
Overactive Bladder
Antidepressants
CNS-Nausea
Prostate Agents
CNS-Parkinson’s
Asthma/COPD
Sleep Aids
Gastrointestinal
CNS-Seizures
Topical Preparations
Anti-Fungals
$ - Generic drugs (listed in all lowercase letters) have the lowest copay
$$ - Preferred brand name drugs (listed in all CAPITAL letters) have the middle copay
$$$ - Non-preferred brand name drugs (listed in all CAPITAL letters on the front of this handout) have the highest copay

Source: http://archive.sbcisd.net/departments/humanResources/files/RxEDO07.pdf