Benefits Plans - Prescription Drug Plan: Prescription Drug Plan Newsletter
Spring 2009
Topics covered in this issue include:
- New Specialty Drug Pharmacy
- SXC now InformedRx
- Drug Plan ID Card
- Shingles Immunization – Zostavax
- Traveling with Medications
- Walgreens Mail Service
- Your Savings Opportunity
- Pill Splitting
- New Generic Medications Available
- Drug Shortages and Recalls
- 2008 U-M Prescription Drug Plan Facts
- E-Prescribing Coming to Michigan
Printable newsletter (PDF)
New Specialty Drug Pharmacy - Wellpartner
Specialty drugs are a covered benefit in the U-M prescription drug plan. These medications require special handling, administration or monitoring. These drugs include self-injectable and some oral medications for conditions such as cancer, rheumatoid arthritis and multiple sclerosis. A list of “Specialty Drugs” is on our website.
Average cost is over $1,500 per month per prescription. Less than 2% of U-M drug plan members use specialty drugs, which represent 16% of all plan claim costs. Specialty drugs are limited to 34 days supply per fill, as doctors may change prescriptions during the course of treatment.
To better support our plan members and help manage the growing cost of specialty drugs, the University will offer Wellpartner Specialty Pharmacy services in the coming months.
All members receiving specialty medication will be sent information about the new service.
Members filling prescriptions at the University health center pharmacies are encouraged to continue using the U-M pharmacies for their specialty drug medications.SXC Member Services Now InformedRx
InformedRx is the new name for SXC Health Solutions prescription drug services. Services for U-M prescription drug plan members remain the same. U-M members use the same “member services” phone number, answering with the new message: “InformedRx, administrator for the University of Michigan Prescription Drug Plan.” Plans are underway to provide new ID cards to U-M members displaying the InformedRx name later in the year.
Your U-M Drug Plan ID Card
Make sure to give your pharmacy your U-M Prescription Drug Plan card to get the U-M co-pay and network contract pricing. Call member services at 866-715-0874 for assistance or visit our website: benefits.umich.edu/plans/drugs
If you cannot use your drug ID card, remember that reimbursement claims received more than 90 days after the prescription fill date cannot be reimbursed. Reimbursement for cash claims received within the 90 day deadline will be reduced to the network drug price less your U-M drug plan co-pay. Reimbursement will always be less than the cash price you paid.
Use your U-M drug plan ID card at a participating pharmacy. It will save you time and money.
Shingles Immunization - Zostavax
U-M medical plans cover the Zostavax injection when administered in a doctor’s office. Check with your medical plan for information about coverage of this injection.Traveling Medications - Vacation Overrides
Planning a trip out of the country? If you maintain your U-M medical coverage during your trip, you can take a supply of medications with you. To get travel medications filled at your local pharmacy, call InformedRx for an extra month supply: 866-715-0874. Call the U-M Benefits Office for longer trips and mail service vacation overrides: 866-647-7657. Helpful tips for U-M travelers are available at: www.benefits.umich.edu/events/travel
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Walgreens Mail Service
There are 48,000 pharmacies in the SXC/U-M Drug Plan network including most major chains. Walgreens Mail Service should only be used for 90-day supplies of maintenance medications on which the patient is already stabilized.
Members can also get a 90-day supply of drugs covered on the U-M plan for 3 months co-pay at network retail pharmacies ( $15 generic / $45 preferred / $90 non-preferred brand). Co-pay at Mail Service is discounted to $10 generic / $30 preferred brand / $60 non-preferred brands.
Drug supplies filled for less than 90 days at Mail Service are billed at the full 90-day mail co-pay. Specialty medications, limited to 34 day supply, are only billed one co-pay. Compounded drugs (drugs custom-mixed by the pharmacist from two or more components) cannot be filled at Walgreens Mail Service.
To register for Walgreens Mail Service, go to the University of Michigan website at: www.walgreenshealth.com/umich
Call Walgreens Mail Service at 800-745-7083 (TTY 800-573-1833),
or print and mail a Walgreens Mail Order Form: www.benefits.umich.edu/forms/drugs.html
Your Savings Opportunity – Best Value
Your best value when using your prescription drug benefits are generics and drugs on the U-M drug plan’s Preferred Drug List. Physicians are encouraged to prescribe generics or brand name drugs from this list when it is appropriate for your condition. Using the list is voluntary. The University supports the PDL generics and preferred drugs as “Best Buys” to keep health care costs and member co-pay expense down.
The University’s Preferred Drug List includes select brand-name drugs and generic drugs. The list is compiled and updated by a team of University physicians and pharmacists who review all FDA-approved drugs. Preferred brand-name drugs are selected on the basis of therapeutic effectiveness, safety, and cost relative to other brand-name drugs used to treat the same conditions.
Currently 90% of U-M drug plan members’ prescriptions are written for or filled with preferred drugs.
The updated University of Michigan Preferred Drug List is available on the Benefits Office Web site at: www.benefits.umich.edu/forms/umpdl.pdf
Pill Splitting
Are you taking a statin (cholesterol-lowering) medication? Talk with your doctor about the U-M Pill-Splitting discount program. When prescriptions for higher-strength simvastatin, lovastatin, and pravastatin, Lipitor and Crestor are written “take one half tablet daily” they qualify for a 50% co-pay reduction. For details, see the Prescription Drug “Special Programs” section on our website: benefits.umich.edu/plans/drugs
Pill Splitting saved 717 members $35,082 in 2008, contributing $190,370 to plan savings.
New Generic Medications Now Available at Pharmacies
Brand Name |
Generic Name |
Used For: |
Adderall XR |
amphetamine salts extended release |
ADHD or Narcolepsy |
Cosopt |
dorzolamide |
Glaucoma |
Depakote |
divalproex |
Migraines or Epilepsy |
Imitrex |
sumatriptan |
Migraines |
Keppra |
levetiracetam |
Epilepsy |
Requip |
ropinirole |
Parkinson's or Restless Leg Syndrome |
Risperdal |
risperidone |
Psychiatric Disorders |
Topamax |
topiramate |
Migraines or Epilepsy |
Trusopt |
dorzolamide & timolol |
Glaucoma |
Yasmin |
Ocella |
Contraception |
Drug Shortages and Recalls
During the recent market shortages of generic metoprolol ER, isosorbide mononitrate and oxycodone, the generic incentive program penalty was temporarily removed from these brand products. For more information about the U-M Prescription Drug Plan costs and generic incentive program, go to our website:
www.umich.edu/~benefits/plans/drugs/costs.htm
Some of the shortages were a result of drug recalls. FDA gave notice of several recalls in the past few months, including 60 medications manufactured by Ethex. The U-M Benefits Office asked the pharmacy or SXC to contact the patient where there was a possibility that a prescription could have been filled from a recalled drug lot. The U-M Benefits Office cannot directly notify patients as it does not have access to patient identity associated with claims data.
2008 U-M Prescription Drug Plan Facts
| 2008 | 2007 | |
Total number of prescriptions dispensed |
922,432 | 905,456 |
Prescriptions dispensed as generic drugs (tier 1) |
69.20% | 63.66% |
Prescriptions dispensed as brand preferred drugs (tier 2) |
19.55% | 22.69% |
Prescriptions dispensed as brand non-preferred drugs (tier 3) |
11.25% | 13.65% |
Average number of prescriptions filled per active faculty, staff or dependent drug plan member |
10.5 | 10.4 |
Average number of prescriptions filled per retiree |
37.8 | 37 |
Total U-M drug cost (M "million dollars") |
$64.7 M | $61.5 M |
Total member drug cost |
$11.5 M | $12.2 M |
Average cost of a generic prescription |
$26.02 | $24.78 |
Average cost of a brand drug prescription |
$210.68 | $177.91 |
Average member cost share per prescription |
$12.52 (15.15%) |
$13.44 (16.48%) |
E-Prescribing Coming to Michigan
The University of Michigan Prescription Drug Plan began supporting e-prescribing in April 2009. Research has shown that e-prescribing reduces the prescribing and dispensing errors commonly encountered with paper prescriptions. Check to see if your doctor belongs to an e-prescribing service.
The University of Michigan in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend or terminate them.