June 2, 2009

Dear Faculty and Staff,

I'd like to share with you some important changes to your prescription drug plan effective July 1, 2009. 

There are two important changes to note:

• The University's prescription drug plan, including the mail order option, will be administered by Express Scripts beginning July 1.
• The University is implementing an Exclusive Home Delivery Program for maintenance prescriptions and a Generics Preferred Program beginning
  July 1.

New Prescription Drug Plan Administrator
Effective July 1, the University's prescription drug plan, including the mail order option, will be administered by Express Scripts.  For a smoother transition, you are able now to contact Express Scripts at 1-866-515-1442 for assistance with your prescription questions.  When asked for identification information, you will need to tell the customer service representative you are an Ohio University employee and have questions regarding prescriptions.

Although new Express Scripts prescription drug cards will be mailed to your home in late June, between now and July 1, you should continue using your current Envision/Rx Options prescription drug card and the IPS mail order pharmacy.

Beginning July 1, if you have an existing refill at a local pharmacy, or a new prescription, simply present the new Express Scripts identification cards to the pharmacist.  You will be able to obtain your prescription and pay the appropriate co-pay.  Co-pay information is available at: http://www.ohio.edu/hr/benefits/healthcare/prescription.cfm

If you have refills remaining for a mail order prescription, your refills will automatically transfer to Express Scripts, except for controlled drugs and compound prescriptions*.  If you need to receive your medication prior to July 15, you are encouraged to request a refill from Envision / IPS before July 1 to ensure that you have no gaps in your medication.

Beginning July 1, you will need to establish an account and payment method with the Express Scripts Mail Order Pharmacy. To establish an account, visit http://www.express-scripts.com or contact Express Scripts directly at 1-866-515-1442. When establishing an account, you will verify your name and address and set up a payment method, such as a credit card. Accounts can not be established until July 1.

*Please note that mail order refills for controlled drugs or compound prescriptions are not allowed to transfer due to federal regulations.  Examples of controlled drugs include Darvocet, Tylenol #3, and Vicodin.  In addition, prescriptions that are over 1 year old or have no refills remaining will not be transferred to Express Scripts.  If you need a refill of a controlled or compound drug, you will need to submit a new prescription to Express Scripts. 

The University's prescription drug plan and benefits will be based on Express Scripts' formulary.  Since formularies vary slightly between companies, it is possible that the co-pay for a medication you are currently taking will increase or decrease.  To learn more about the Express Scripts formulary, visit:   http://www.ohio.edu/hr/benefits/healthcare/prescription.cfm

Generics Preferred and Exclusive Home Delivery Programs
The University will also be implementing a Generics Preferred Program and Exclusive Home Delivery Program beginning July 1.

With the Generics Preferred program, when filling a prescription or a refill for a brand-name drug, the pharmacist will check whether a generic drug is available.  If a generic is available, employees are encouraged to utilize the generic option, which may reduce your co-pay.  If a generic is available and you or your physician chooses to use the brand name instead of the generic drug, you will be charged the full cost difference between the generic and the brand-name drug.  If there is no generic option available, you will be charged the normal brand name co-pay, which is less than the full cost of the brand name drug. The Generics Preferred Program applies to both prescriptions filled at a local pharmacy and for mail order prescriptions. 

If you are allergic to a generic medication, if there is a medically relevant reason to use a brand name instead of a generic, or your physician wants a specific brand name drug to be utilized, you and your physician can apply for a waiver to the Generics Preferred Program. Your physician must contact Express Scripts to provide the reasons the brand name drug must be utilized.  Express Scripts will review the clinical details and determine whether the Generics Preferred Program can be waived.  If a waiver is granted, the normal brand name co-pay will be applied for that medication.

The Exclusive Home Delivery Program pertains to maintenance medications, or those that are taken routinely over an extended time period.  As an example, Lipitor is a maintenance medication that is taken on an ongoing basis to control high cholesterol.

Under the Exclusive Home Delivery Program, you can fill a prescription of a maintenance medication up to two times at a retail pharmacy such as CVS, Wal-Mart, or Kroger.  After that, the University's health plan will cover a maintenance medication only if it is ordered through Express Scripts Mail Order Pharmacy. 

By using the Express Scripts Mail Order Pharmacy, employees will save money on their co-payments for maintenance medications. Plus, they will receive:

• Free shipping  of their medication.
• Up to a 3-month supply of medication with each order.
• 24-hour access to a pharmacist.
• Refill reminders via phone or email.

While the change to Express Scripts and implementation of the Generics Preferred and Exclusive Home Delivery programs are effective July 1, you can contact Express Scripts beginning today at 1-866-515-1442 with questions regarding your prescriptions. 

Cordially,
Greg Fialko
Director of Benefits
University Human Resources