Medications Requiring Step Therapy
| Step Therapy Group Description | Step Therapy Sequence | Step Therapy Criteria |
|---|---|---|
| Oxycontin Step Therapy | Step-1:MORPHINE SULFATE ER | |
| Step-2:OXYCONTIN | Step-1 medications are covered at the point of service.Step-2 medications require the prior use of a Step-1 medication within the same step therapy group within the previous 180 days as evidenced by a previous paid claim under the prescription benefit administered by Express Scripts or by physician documented use. Patients who have tried the Step-2 Medication being requested: Members that have taken the same Step-2 medication that is being requested within the last 180 days can receive the medication without trial and failure of a Step-1 medication. For the Oxycontin Step Therapy Group, Step-1 is generic extended release morphine sulfate. For the Oxycontin Step Therapy Group, Step-2 is Oxycontin. This Step Therapy Group is in place for New Starts Only. |
Last Modified on 05/08/2013