Step Therapies Title Image

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  
      Platinum  
      Gold  
      Silver  
      Bronze  

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 a Step Therapy.

      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