Important Information about Lipitor Coverage for Members with Copay Prescription Plans

Introducing a Limited-Time ‘House Generic' Lipitor Program

We are sharing cost-saving news with members who have copay prescription plans. Through a special, limited-time program for Independence Blue Cross members, the brand-name drug Lipitor will be available at a Tier 1 copay, meaning at the lower generic drug cost. Lipitor is a drug commonly prescribed to treat high cholesterol. On November 30, 2011, Lipitor will become available in a generic form called atorvastatin. This program will apply to both self-insured and fully insured business.

Stay with Lipitor for the near-term; switch to atorvastatin next year

Generic drugs save money for many health care consumers and the health care system overall. Even though Independence Blue Cross encourages the use of generics when they are available, we are offering members the brand Lipitor drug at the generic copay level for a six-month period from November 30, 2011, through May 31, 2012. On June 1, 2012, atorvastatin will be available to members at the generic copay level, and Lipitor will move to a higher copay level.

This offer is made available to members through a special arrangement with Lipitor's manufacturer. IBC remains committed to the use of generic drugs as they are typically the lowest-cost formulary option and are often prescribed as preferred alternatives to brand-name medications. Clinically, generic atorvastatin and brand Lipitor are equivalent.

What does this mean for members who take Lipitor and have a copay prescription plan?

The dates below are important for members who take Lipitor and have a copay program for their prescription coverage.

November 30, 2011. Lipitor will move to the formulary's Tier 1 or generic copayment (meaning members will pay a generic copayment when purchasing the brand drug Lipitor). Atorvastatin (generic Lipitor) will not be covered during these first six months until June 1, 2012.
June 1, 2012. Brand Lipitor will become a non-preferred drug and will move to formulary Tier 3 (highest copay). Therefore, beginning June 1, 2012, prescriptions for Lipitor should automatically be filled with atorvastatin at their participating pharmacy. Members will continue to pay the same Tier 1 or generic copayment (lowest copay).

Members do not need to contact their physicians, obtain a new prescription, or make any other changes. Beginning November 30, 2011, mail order or participating retail pharmacies will continue to provide members with brand-name Lipitor but they will pay the generic copayment. Beginning June 1, 2012, members' participating pharmacies should automatically fill their prescriptions with Lipitor's generic equivalent, atorvastatin.

What does this mean for members who take Lipitor and do not have a copay prescription plan?

This special limited time program does not apply to members who have deductible prescription programs, discount card plans, or coinsurance plans. For members with these programs, the brand Lipitor will become a nonpreferred drug and will move to formulary Tier 3 (highest cost-sharing level) effective January 1, 2012. This timing coordinates with the quarterly formulary change schedule. Beginning January 1, prescriptions for Lipitor should be filled with atorvastatin at the lowest cost-sharing level.

Communications about the Lipitor change

Members who take Lipitor and have a copay prescription program will receive a letter communicating this good news within the next week. As this communication is only being mailed to members, we encourage you to notify group administrators of this special program so they are aware of their members' access to this significant cost savings. Self-funded groups will receive this communication from their IBC account executive this week about this cost-saving program.

If you have any questions, please contact your Independence Blue Cross account executive.

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Independence Blue Cross offers products directly, through its subsidiaries Keystone Health Plan East and QCC Insurance Company, and with Highmark Blue Shield. Independent licensees of the Blue Cross and Blue Shield Association.

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