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Drugs Requiring Step Therapy

Step Therapy requires the trial and failure of one or more prerequisite drugs before the step therapy medication will be covered. Step therapy promotes the appropriate use of equally effective but lower cost drugs, most often generics, as first line therapy.

If the drug you are looking for is not listed in the chart below, please check Drugs Requiring Prior Approval and Drugs Subject to Quantity Limits.

Pharmacy Policy Update Notifications - Please note the draft policies are highlighted below with effective dates. Any provider comments on the policies should be sent 30 days prior to the effective date. Send them to pharmacycomments@shpnc.org.

**TO INITIATE A COVERAGE REVIEW, providers should visit www.medco.com/coverage or call 800-753-2851**

Drugs Requiring Step Therapy Step Therapy Policy More Information
Androgens and Anabolic Steroids
Effective July 2, 2012		 Androgens and Anabolic Steroids  
Angiotensin II Blockers (ARBs) Angiotensin II Blockers (ARBs) Click here
Atypical Antipsychotics Atypical Antipsychotics Click here
Fertility Agents Fertility Agents Click here
Glaucoma Agents Glaucoma Agents Click here
Growth Stimulation Drugs Growth Stimulation Drugs Click here
Migraine Medications Migraine Medications Click here
Multiple Sclerosis Agents MS Agents Click here
Nasal Steroids Nasal Steroids Click here
Non-sedating Antihistamines Non-sedating Antihistamines  

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Drugs Requiring Prior Approval Step Therapy Policy More Information
Oracea (Doxycycline Delayed Release capsules) Oracea (Doxycycline Delayed Release capsules) Click here
Osteoporosis Medications Click here
Pulmonary Arterial Hypertension Agents
Effective July 2, 2012		 Pulmonary Arterial Hypertension Agents*  
Proton Pump Inhibitors  
Rheumatoid Arthritis Agents Click here
Rheumatoid Arthritis Agents
Effective July 2, 2012		 Orencia  

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Drugs Requiring Prior Approval Step Therapy Policy More Information
Sedative Hypnotic Agents Sedative Hypnotic Agents Click here
Selective Serotonin Reuptake Inhibitors (SSRIs) Selective Serotonin Reuptake Inhibitors  
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) Pristiq  
Solodyn® (minocycline extended-release tablets) Solodyn® Click here
Topical Diclofenac Products Topical Diclofenac Products Click here

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