Retiree - Step Therapy
The Right Medicine at the Right Cost
Step Therapy is a program designed exclusively for people who have certain conditions—arthritis, high blood pressure, and high cholesterol, for example — that require them to take medications regularly. Express Scripts’ Step Therapy program is all about value — about getting the most for your money. Most simply, that means getting a tried-and-true medication that’s proven safe and effective for your condition, and getting it at the lowest possible cost.
The lowest-cost Step Therapy drugs also save money for your prescription-drug plan, and that helps ensure that your pharmacy benefit will be there for you and your family in the future.
What is Step Therapy?
In Step Therapy, drugs are grouped in categories, based on cost:
- Front-line drugs — the first step — are generic drugs proven safe, effective and affordable. These drugs should be tried first because they can provide the same health benefit as more expensive drugs, at a lower cost.
- Back-up drugs — Step 2 and Step 3 drugs — are brand-name drugs such as those you see advertised on TV. There may be lower-cost brand drugs (Step 2) and higher-cost brand drugs (Step 3). Back-up drugs typically cost more than front-line drugs.
How It Works
The next time your doctor writes you a prescription:
- Ask your doctor if a generic medication—listed by your plan as a front-line drug—is right for you.
- If you’ve already tried a front-line drug, or your doctor decides one of these drugs isn’t appropriate for you, then your doctor can prescribe a back-up drug. Ask your doctor if one of the lower-cost brands (Step 2 drugs) listed by your plan is appropriate.
- You can always get a higher-cost brand-name drug at a higher copayment if the front-line or Step 2 back-up drugs aren’t right for you.
Talk With Your Doctor
Only your doctor can advise you about the drugs you take, so talk with your doctor about your medications. Give your doctor a copy of the front-line drugs covered under your plan and ask if one is right for you.
Step Therapy Helps You Get the Most Out of Your Prescription-Drug Benefit
For more information on how Step Therapy works and how it benefits you, watch this short video at www.StepTherapyFacts.com.
A generic front-line medication will cost, on average, between 30% and 80% less than the equivalent brand-name drug.