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40113 ChoiceRx ePub long (1)

Therapeutic Class MAC Program For more information about our Choice Rx Solutions Advantage, please contact: Dino Dibella (217) 720-3085 Choice Rx Solutions is an innovative new PBM that prides itself on developing creative pharmacy benefit options and cost containing programs. Our Therapeutic Class MAC program is a groundbreaking benefit plan design that significntly lowers the cost of our clients’ prescription drug programs. Our Therapeutic MAC program was developed as a method to control the rising cost of prescription drugs. It is a reference based pricing program that closely manages utilization in 24 of the most common therapeutic categories using relative therapeutic pricing. The Therapeutic Class MAC program utilizes our National Formulary to promote the appropriate use of cost effective medications in the top therapeutic drug categories – diabetes, depression, anxiety, stomach problems, high blood pressure, ADHD, birth control, and others. While the Therapeutic MAC program uses traditional formulary tiers and mandatory generic dispensing, it also promotes the use of generics and preferred brand drugs in the categories noted above. In the Therapeutic Class MAC program, non-preferred products are assigned a daily plan allowance calculated using a preferred product. Generic and preferred brand drugs maintain the copay of your standard benefit design, while members pay the amount above the Therapeutic MAC program allowance when using nonpreferred brand drugs in the Therapeutic Class MAC categories. For drugs in one of the primary therapeutic categories evaluated in the Therapeutic MAC program, the member’s copay will be: • Generic Drugs Tier 1 (generic) copay applies • Preferred Brand Drugs Tier 2 (preferred) copay applies • Non-Preferred Brand Drugs Tier 3 (non-preferred) copay plus penalty For drugs not in the primary therapeutic categories, the member’s copay will be: • Generic Drugs Tier 1 (generic) copay applies • Preferred Brand Drugs Tier 2 (preferred) copay applies • Non-Preferred Brand Drugs Tier 3 (non-preferred) copay applies * – Incudes entire family of products ** – Includes all combination products with HCTZ, etc.   11


40113 ChoiceRx ePub long (1)
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