Step therapy is a program designed especially for people who take prescription drugs regularly to treat ongoing medical conditions, such as arthritis and high blood pressure. The program may require you or family members to try a generic drug before moving to a higher-cost brand-name drug. Only your physician can provide a prior authorization for a higher-cost drug. With step therapy, drugs are grouped
in categories, based on cost:
• Step 1 drugs — Generic equivalents which have proven safe, effective, and affordable. They should be tried first because they can provide the same health benefit as more expensive drugs, at a lower cost, saving you and the company money.
• Step 2 drugs — Brand-name drugs on the Caremark formulary (list of preferred drugs) that are less expensive than brand-name non-formulary drugs.
• Step 3 drugs — Brand-name drugs that are not on the Caremark formulary and are therefore more expensive than step 2 drugs. These drugs are the most expensive option. Purchase through the mail-order program (for long-term or maintenance prescriptions).
To find out where your medication falls on the Caremark formulary, you can call Caremark at 1-866-240-4921.
