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Home > Health
Care Professionals > Prescription Drug List
> Maintenance Drugs
Certain prescription medications are classified as maintenance
drugs, meaning they are commonly prescribed for six months or longer to treat
a chronic condition. A list of maintenance drugs is developed and updated by our
Pharmacy and Therapeutics Committee. The committee is comprised of independent,
practicing physicians from various medical specialties as well as independent,
practicing pharmacists. The committee meets regularly to review new and existing
medications in all therapeutic categories and to evaluate them based on safety
and efficacy. The committee also analyzes prescribing patterns for individual
drugs and drug classes to determine whether they should be categorized as maintenance
drugs.
A physician determines whether or not the enrollee meets
the criteria of requiring a maintenance drug. An enrollee may obtain
a three-month supply of medication when the prescription is filled if the medication
is on the list of maintenance drugs.
If a medication is not on our list of maintenance drugs, but
the enrollee's physician is writing a prescription for greater than a one-month
supply,
the physician must request pre - authorization to prescribe the medication as
a maintenance drug. To do so, the physician should submit medical documentation, including diagnosis and any relevant treatment
information, to MEDCO; call 1-800-753-2851 for more information. An enrollee may still obtain a one-month supply of a non-maintenance drug while the
physician is requesting that the drug be approved as maintenance.
Click here to view the
list of maintenance drug classes developed by our Pharmacy and Therapeutics Committee.
The list is subject to change.
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