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Drug Name Search

By Therapeutic Class

OHSU Employee Benefit Plans

Welcome

The prescription drug list displays coverage of drugs under OHSU Employee Benefit Plans when filled at an in-network pharmacy.

Drugs are reviewed by a team of pharmacists and physicians who review drugs for safety, effectiveness, and value. The prescription drug list is reviewed regularly and is subject to change. For changes that may negatively affect the coverage of a drug you are taking, a notice will be provided to you at least 30 days in advance.

Printable File

For a copy of the prescription drug list, click the link below:

How to Search

  • Drug name: You can look up the drug by its name
  • By Use: Drugs used to treat the same or similar conditions are listed together

Tier Description

Tier levels are assigned to drugs that correspond with your cost-share for the drug. Generally, drugs listed at lower tiers cost less than drugs listed at higher tiers.

Tier Description
1 Valued generic drugs and brand drugs
2 Preferred Generic Drugs
3 Non-preferred generic drugs and preferred brand drugs
4 Non-preferred brand drugs
5 Preferred specialty generic drugs
6 Non-preferred specialty generic drugs and preferred specialty brand drugs
7 Non-preferred specialty brand drugs

If you or your provider request to fill a brand drug for which there is an FDA approved generic equivalent available, you may be responsible for the brand drug’s cost-share plus the cost difference between the brand drug and generic drug.

For a complete description of your cost-share at each tier, refer to your pharmacy benefits handbook.

Limits & Restrictions

Drugs that have limits or restrictions are listed in these ways:

Indicator Description
Prior Authorization (PA) These drugs require prior approval before they are able to be covered by your plan
Step Therapy (ST) You may need to first try another drug or series of drugs before the drug will be covered by your plan
Quantity Limit (QL) A limited amount of the drug is covered without prior approval
Age Limit (AL1) These drugs are covered only for certain ages
Specialty Drug (S) These drugs require that you fill the drug at a specialty pharmacy and may have additional restrictions
Preventative Care (ACA) These drugs are covered under the Affordable Care Act at no member cost-share when prescribed by a licensed healthcare provider and specific criteria is met

Authorization/Exception Request Process

To request coverage for a drug that is not covered or has limits or restrictions, your provider will need to complete the Authorization Request Form and provide supporting clinical documentation. Once we receive the request, we will review to determine whether the plan is able to cover the drug. For specific coverage criteria, please have your provider contact our Customer Service Department at the number below.

Pharmacy Network

Most drugs on the prescription drug list may be filled at an in-network retail or mail-order pharmacy. Drugs with a specialty indicator must be filled at a specialty pharmacy. For information about pharmacies in-network, contact our Customer Service Department at the number below.

More Information

If you have questions or need help, visit our website or call our Customer Service Department Monday through Friday 8:00am to 5:00pm PST.

Website: www.ohsu.edu/pbm

Toll-Free: 1-833-247-6880

TTY: 503-494-0550

Legend

TIERING
  • T1
    - Valued generic drugs and brand drugs
  • T2
    - Preferred Generic Drugs
  • T3
    - Non-preferred generic drugs and preferred brand drugs
  • T4
    - Non-preferred brand drugs
  • T5
    - Preferred specialty generic drugs
  • T6
    - Non-preferred specialty generic drugs and preferred specialty brand drugs
  • T7
    - Non-preferred specialty brand drugs
  • NF
    - Non-Formulary