Step Therapy Program
Lists drug categories and example medications that are subject to step therapy programs under the payer's prescription drug benefit. Indicates that programs may change and that members/providers can request an exception review via the phone number on the member ID or the provider website.
Lists example drugs within categories that may be included in the step therapy program (Performance Drug List).
Summary of Changes
This bulletin clarifies that the document provides illustrative brand and generic examples across multiple drug categories that may be subject to step therapy on the Performance Drug List, including atopic dermatitis, atypical antipsychotics, depression, gabapentin ER, insomnia, Kerendia category, and topical NSAIDs. The examples shown are illustrative and the programs and listed drugs may change from time to time.
Statistics surfaced in the brief show 9 drug categories listed and multiple example medications; these counts reflect the bulletin's scope but the specific examples are illustrative and may be updated.
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