Quantity Limits
We will reimburse to the quantity limits considered safe and effective by the U.S. Food and Drug Administration and the drug manufacturer for a 30-day supply. These drugs may require preauthorization depending on the quantity dispensed. If your doctor believes the quantity limits do not meet your needs, he or she can call (800) 753-2851.
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Prior Authorization
The WEA Trust requires your doctor to call (800) 753-2851 for prior approval before we pay for these drugs.
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Generic Drug
Before a pharmaceutical company begins selling a brand name drug, it gets a patent (exclusive right) for the drug. That means for a specific period--usually several years--only that company can manufacture and sell the patented drug. Once patent protection runs out, other manufacturers can produce the drug in generic form.
Generic drugs face the same strict scrutiny from the Food and Drug Administration (FDA) as brand-name medications. To win FDA approval, a generic drug must have the same active ingredients as the brand-name form and be subject to the same standards of quality, strength, and purity. Additionally, the manufacturer must prove that the generic drug will be absorbed at a similar rate and in a similar amount as the brand-name medication.
The main difference between brand-name and generic medications is that the generic may contain different inactive ingredients such as fillers and dyes. These ingredients affect how the drug looks but do not change its effectiveness. A very small number of people, however, can have an allergic reaction to inactive ingredients. Be sure to check with your doctcor or pharmacist about any possible side effects you may experience.
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Step Therapy
Step therapy means you have to first try one drug to treat a condition before another drug to treat that condition is covered. Step therapy promotes safe and cost-effective drug utilization based on clinical protocols agreed to by medical experts, the makers of the drugs, and the Food and Drug Administration (FDA). Members with a new prescription for a drug requiring step therapy must try a first-line treatment or have their doctor call (800) 753-2851 for prior approval before receiving coverages.
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