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Step Therapy

Step Therapy is a program designed to encourage the safe and cost-effective use of medication. Organized into a series of steps, the program requires the member to try a “first-line medication” before a “second-line medication” will be covered through the prescription drug plan. First-line medications are widely recognized as safe and effective in treating a specific medical condition. Second-line medications are either preferred or non-preferred brand-name drugs, and are generally more costly. When possible, a provider should prescribe a first-line medication appropriate for a condition. If he or she determines that a first-line medication is not appropriate or is not effective in treating a condition, the prescription drug benefit will cover a second-line drug.

Step Therapy Requirements
Drug ClassTargeted Medications 1
(Second-Line Medication)		Recommended Alternatives
(First-Line Medication)
AndrogensAndroderm, TestimAndroGel
Angiotensin II Receptor Blockers
Blood Pressure		Atacand/HCT, Avalide, Avapro, Benicar/HCT,
Teveten/HCT, Edarbi		losartan, losartan/hctz, Diovan/HCT, Micardis/HCT
Atypical Antipsychotics2Abilify, Fanapt, Invega, Saphris,
Latuda		risperidone, Geodon, Seroquel, Zyprexa
Bisphosphonates
Osteoporosis		Actonel, Actonel with Calcium, Atelviaalendronate, Boniva, Fosamax Plus D
Growth Hormones3Nutropin, Omnitrope, Saizen, Serostim,
Tev-Tropin, Zorbitive		Genotropin, Humatrope, Norditropin
Hypnotics
Sleep Aids		Ambien CR, Lunesta, RozeremAll preferred generic hypnotics
Intranasal Steroids
Nasal Allergy		Beconase AQ, Nasacort AQ, Omnaris,
Rhinocort Aqua, Tri-Nasal, Vancenase AQ, Veramyst		flunisolide, fluticasone propionate, Nasonex
Proton Pump Inhibitors
Ulcer		lansoprazole, AcipHex, Dexilant, Prevacid, Prevacid SoluTabs, Prilosec packets, Protonix, Zegeridomeprazole, Nexium
Selective Serotonin
Reuptake Inhibitors2
Depression		Lexapro, Luvox CR, Pexevacitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline
Triptans
Migraine		Axert, Frova, Sumavel, Treximet, Zomignaratriptan, sumatriptan, Maxalt, Maxalt-MLT, Relpax

Note: Lists are subject to change throughout the year.