AsthmaXolair

1
Specialty Pharmacy ProgramMedical Benefit Drugs
Therapeutic Class Drug
Therapeutic Class Drug
Asthma Xolair Factor Products Advate Alphanate A
lphanine Autoplex Bebulin Benefix Feiba Helix
ate FS Hemofil Humate Koate Kogenate Konyne
Monarc Monoclate Mononine NovoSeven Profilnine
Proplex Recombinate Refacto
Gaucher's Cerezyme PPH Flolan Remodulin Psorias
is Amevive Rheumatoid Arthritis Remicade RSV Syn
agis
Drugs Under Both Benefits
Therapeutic Class Drug
Anemia/neutropenia Aranesp Epogen Neulasta Neup
ogen Procrit
examples only not a comprehensive list
2
Specialty Pharmacy ProgramPharmacy Benefit Drugs
Therapeutic Class Drug
Therapeutic Class Drug
Therapeutic Class
Drug
Therapeutic Class
Drug
Growth Hormone Genotropin Humatrope Increlex No
rditropin Nutropin Saizen Serostim Tev-Tropin Z
orbtive Hepatitis C Copegus Infergen Intron
A Pegasys Peg-Intron Rebetol Rebetron Ribavir
in
Multiple Sclerosis Avonex Betaseron Copaxone Re
bif Rheumatoid Arthritis Enbrel Humira Kineret
Psoriasis Raptiva Enbrel
Drugs Under Both Benefits
Therapeutic Class Drug
Anemia/neutropenia Aranesp Epogen Neulasta Neup
ogen Procrit
examples only not a comprehensive list
3
The Specialty Pharmacy Referral Line directs
members to the appropriate specialty pharmacy

• Toll-free telephone number 866-429-8177
• 24 hours a day/365 days a year
• Trained customer service representatives (CSRs)
  answer questions and explain the process
• CSRs are fully trained on the program and
  protocols for directing members to the right
  pharmacy

4
Quality Assurance is an integral part of the
network strategy
As of January 1, 2007, implemented nationally for
more than 4.9 million members