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Step Therapy
Prescription Management Program

Certain medications covered under the OPEH&W Health Plan require the use of an equally effective and less expensive prescription medications before a more expensive alternative will be considered for coverage. The OPEH&W Health Plan’s Prescription vendor administers the Step Therapy process on behalf of the OPEH&W Health Plan.

Use the following links to access the Express Scripts (ESI) Formulary for each health coverage option:
   Diamond Link
   Platinum Link
   Gold Link
   Silver Link
   Bronze Link
The OPEH&W Health Plan reserves the right to adjust this list from time to time as required
If in doubt, contact the Health Plan Administration Office to verify whether a covered medication is subject to Exclusion

Step Therapy Medications:
Acne Medications (Oral) such as Oracea & Solodyn
Anti-Diabetic Injectables such as Byetta
Anti-Inflammatory Drugs such as Celebrex
   》Must first try generic non-steroidal Anti-Inflammatory drugs before Celebrex will be covered
Hypnotics such as Ambien
Overactive Bladder Drugs such as Detrol
Glucose Transporters such as Invokana
Topical Immunomodulators such as Elidel
Topical Corticosteroids such as Topicort
Topical Acne Drugs such as Metrogel
Ophthalmic Anti-Allergy Drops such as Pataday