Introduction to EHP Pharmacy
The Johns Hopkins Employer Health Program (EHP) administers pharmacy benefits for
the following groups: Johns Hopkins Hospital/Health Systems, Johns Hopkins Bayview Medical Center,
AON Corporation, Chester River Hospital Center, Broadway Services Incorporated, and
the Johns Hopkins University Student Health Program.
The Johns Hopkins Employer Health Program (EHP) is pleased to provide the 2009
formulary in support of the 2009 Prescription Drug Plan for select EHP groups. This formulary applies
to the following EHP groups, Johns Hopkins Hospital/Health Systems, Johns Hopkins Bayview Medical
Center, AON Corporation, Chester River Hospital Center and Broadway Services, Incorporated and Johns
Hopkins University Student Health Program. All information in this 3 Tier formulary is provided as a
reference for drug selection. Specific drug selection for an individual patient rest solely with the
prescriber.
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NOTICE
The information contained in this EHP formulary and its appendices are provided by EHP solely for the convenience of medical providers. EHP does not warrant or assure accuracy of such information, nor is it intended to be comprehensive in nature. This formulary is not intended to be a substitute for the knowledge, expertise, skill, and judgment of medical provider in their choice of prescription drugs. EHP assumes no responsibility for the actions or omissions of any medical provider based upon reliance, in whole or in part, on the information contained herein. The medical provider should consult the drug manufacturer’s product literature or standard references for more detailed information.
PREFACE
The formulary is organized by sections. Each section includes therapeutic groups identified by either a drug class or disease state. Products are listed by generic name. Brand names are included as a reference to assist in product recognition. The 3 Tier Formulary is an open formulary; most drugs are covered, whether on formulary or not.
The formulary places drugs into tiers in the following manner:
Tier 1: Lowest plan participant co-payment: All generic drugs, including those on formulary as well as non-listed generic products.
Tier 2: Intermediate plan participant co-payment. Brand name drugs on formulary selected for Tier 2.
Tier 3: Highest plan participant co-payment. Brand name drugs on formulary not selected for Tier 2.
GENERIC SUBSTITUTION
Brand name drugs that have commercially available generic equivalents may:
- Incur a higher co-payment (Tier 3)
- Require payment of the difference in price between generic and brand, in addition to applicable co-payment
- Require mandatory generic dispensing
PRIOR-AUTHORIZATION
Certain medications require prior-authorization before coverage is approved, to ensure medical necessity, clinical appropriateness and/ or cost
effectiveness: (Click on link to view prior-authorization criteria request form.) Use “Clinical
Prior-authorization Criteria Request Form” for non-injectable drugs. Use “Specialty Medication
Prior-authorization Criteria Request Form” for injectable medications.
INJECTABLE DRUGS
Formulary listing of injectable drugs does not guarantee coverage. Please consult individual member's benefit plan to determine drug coverage.
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