Step Therapy Guidelines

Step therapy is in place for the drugs listed below. Step Therapy is the practice of beginning drug therapy for a medical condition with the most cost-effective and safest drug and progressing to other more costly or risky therapy, only if necessary (i.e., you must try drug "A" before you can get drug "B"). The goal is to control costs and minimize risks. Step therapy is an automated process. If a prescription is presented for a "step therapy" drug (i.e., "B") to a pharmacy, an automated check of the member's prescription history will occur. If the system finds that the member has received the qualifying drug(s) (i.e., "A"), the prescription will be processed. If the system does not find the qualifying drug (i.e., "A") in the member's recent history, a prior authorization will be necessary. The step therapy guidelines are developed and reviewed by a panel of practicing physicians and pharmacists.

Click on the drug name below to view the specific step therapy guidelines

Commercial Guidelines:
ARB and ARB Combo ST
Abilfy Seroquel ST
Amrix and Fexmid ST
Aptensio XR ST and QL
Atypical Antipsychotics ST
Arava ST
Aricept ST
Aromatase Inhibitors ST
Avandia Products ST
Caverject_Edex ST
Celebrex ST
Clarinex_Allegra Xyzal ST
Conzip ST and QL
Crestor ST
Daliresp ST
Fetzima ST
Dificid ST
Forfivo ST
GLP-1 Agonists ST
Hep B Agents ST
Horizant ST
Hypnotics ST
Inspra ST
Liptruzet ST
Myrbetriq ST
Nasal Steriods ST
Neupro ST and QL
Non-Sedating Antihistamines ST
Oral Proton Pump Inhibitors ST
Osteoporosis ST
Potiga ST
Pristiq ST
Simcor ST
Singulair ST
Tekturna ST
Treximet ST
Triptan Agents ST
Uloric ST and QL
Vimovo ST and QL
Vytoria-Zetia ST
Xopenex ST
Zipsor ST and QL 

Last Updated: 09/28/2015