Guide to January 1, 2019 Prescription Drug Changes

If you receive notification that you are among those affected by the prescription changes effective January 1, 2019, use the guide below for information pertinent to your situation(s).

 

My medication now requires prior authorization…
If your prescription now requires prior authorization, you have three options:

  1. Have your doctor contact Express Scripts at (800) 753-2851.
  2. Have your doctor prescribe a different, clinically equivalent medication that does not require prior authorization.
  3. Continue taking your current medication without prior authorization and pay full cost.

 

My medication now requires step therapy…
If your prescription now requires step therapy, follow the following three steps before you attempt to fill your prescription:

  1. Share the notification letter you received from Express Scripts with your doctor and ask if one of the preferred alternatives could work for you.
  2. If a preferred alternative can work for you, your doctor can write a new prescription to replace your current one. *
  3. Fill the prescription for the preferred alternative to avoid paying the full cost for your current medication going forward.

*If a preferred alternative cannot work for you, your doctor should contact Express Scripts at (800) 417-1764 to request authorization to continue your current medication. If approval is not granted, however, you will need to find a preferred alternative or pay full price to continue with your current medication.

My medication must now be purchased through Accredo Specialty Pharmacy…
If your prescription must now be filled through the Accredo Specialty Pharmacy, follow the guidelines below:

  1. If you already get the affected medication(s) through Accredo, you do not need to do anything.
  2. If you previously obtained your own prescriptions for the affected medication(s) and took them to your doctor or hospital to be administered, you will now be required to order those medications through Accredo.
  3. If your provider previously obtained your affected prescriptions from a source other than Accredo, your provider will now be required to order those medications through Accredo.
For additional assistance, contact Accredo at the numbers below:
Accredo Customer Service: (800) 803-2523
Monday-Friday: 8:00 a.m. to 11:00 p.m., Eastern Time
Saturday: 8:00 a.m. to 5:00 p.m., Eastern Time
Accredo Prescription Fax Line: (800) 391-9707

Physician Customer Service: (800) 987-4904, Option 5