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Home > Health Care Professionals > Prescription Drug List > Maintenance Drugs

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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