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Q: Osteoporosis Drugs - Formulary Positioning ( Answered 5 out of 5 stars,   0 Comments )
Question  
Subject: Osteoporosis Drugs - Formulary Positioning
Category: Business and Money
Asked by: bkelly2001-ga
List Price: $30.00
Posted: 31 Mar 2003 18:13 PST
Expires: 30 Apr 2003 19:13 PDT
Question ID: 183943
I'm looking for the formulary positioning (i.e. 2nd Tier vs. 3rd Tier)
for two osteoporosis drugs, Fosamax and Actonel at top MCOs(managed
care organizations) These include:

MCOs (United Healthcare, Aetna, Cigna, Anthem, Wellpoint, Humana,
HealthNet, PacifiCare, Coventry and Oxford)

I would like information on the tier both Actonel and Fosamax are`on
(i.e. both 2nd Tier, or Fos. 2nd Tier, Actonel 3rd Tier) for
at least ten top health plans.  Data for the ten plans listed above
would be ideal.  If not, at least 7 or 8 of the plans listed above
must be included and can be supplemented with 4-5 other plans not
listed.
Answer  
Subject: Re: Osteoporosis Drugs - Formulary Positioning
Answered By: websearcher-ga on 31 Mar 2003 19:21 PST
Rated:5 out of 5 stars
 
Hi bkelly2001:

I have been able to find the formulary information for each of the ten
MCOs that you listed. Since many of them use different terminology,
you may need to follow the links provided to find out *all* the
details about their plans. I have tried to add "extra" information,
such as whether prior authorization is required or whether there are
quantity limits.


United Healthcare
http://www.unitedhealthcare.com/uht/files/Content/PDF/50.pdf
http://www.milwaukeemedicalsociety.org/uploads/Prescribers%20Guide%20-%20Milwaukee.pdf
Actonel --- second tier
Fosamax --- second tier


Aetna: 
http://www.aetna.com/formulary/2003_3-tier_aushc_mbr_guide.pdf
Actonel --- middle copay
Fosamax --- middle copay


Cigna
http://www.groupus.com/groupus/cigna/Cigna%20Formulary.pdf
Actonel --- higher tier copay
Fosamax --- second tier copay


Anthem
http://www.anthemprescription.com/formulary_print.asp
Actonel --- brand name [second level] (on formulary)
Fosamax --- brand name [second level] (on formulary)


Wellpoint
http://www.wellpointrx.com/vis/vis_alphaFormTOC.html
Actonel --- brand name [second level] (on formulary)
Fosamax --- brand name [second level] (on formulary)


Humana
http://apps.humana.com/prescription_benefits_and_services/execreq.asp?processcode=40&productid=3&drug=ACTONEL&ndc=001490470
http://apps.humana.com/prescription_benefits_and_services/execreq.asp?processcode=40&productid=3&drug=FOSAMAX&ndc=000060031
Actonel --- 2nd level (of four)
Fosamax --- 2nd level (of four)


HealthNet
http://www.healthnet.com/pharmacy/members/commercial.asp
Actonel --- 2nd level (prior authorization required)
Fosamax --- 2nd level (prior authorization required)


PacificCare
http://www.rxsolutions.com/clientformulary/FormularySearchResult.asp?state=CA&searchText=actonel&infoid=CA&page=undefined
http://www.rxsolutions.com/clientformulary/FormularySearchResult.asp?state=CA&searchText=fosamax&infoid=CA&page=undefined
Actonel --- 2nd level (prior authorization required)
Fosamax --- not covered


Coventry
http://coventry.formularies.com/single_drug_disp.asp?drugname=Actonel&drugtype=1
http://coventry.formularies.com/single_drug_disp.asp?drugname=Fosamax&drugtype=1
Actonel --- 2nd tier (quantity restrictions)
Fosamax --- 2nd tier (quantity restrictions)


Oxford
https://www.oxhp.com/secure/broker/pharmacy_info/drug_list.html
Actonel --- 3rd tier (quantity restrictions)
Fosamax --- 2nd tier (quantity restrictions)


I hope this information helps with your research.             
             
If you need any clarification of the information I have provided,
please ask using the clarification feature and provide me with
additional details as to what you are looking for. As well, please
allow me to provide you with clarification(s) *before* you rate this
answer.
             
Thank you.              
             
websearcher-ga              
             
             
Search Strategy (on Google):              

[COMPANY NAME] formulary
[COMPANY NAME] fosamax actonel
bkelly2001-ga rated this answer:5 out of 5 stars
Great. Just what I needed, with links provided, additional clarifying
detail and answered promptly. thanks.

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