How to get covered drugs or supplies Network pharmacies are located in many network facilities. To find a network pharmacy, visit kp.org/directory, or contact Member Services to ask us to mail you a pharmacy directory. Network pharmacies include our mail-order pharmacy. This pharmacy offers postage-paid delivery to addresses in Oregon and Washington. Some drugs and supplies are not available through our mail-order pharmacy, for example, drugs that require special handling or refrigeration, or are high cost. Drugs and supplies available through our mail-order pharmacy are subject to change at any time without notice. If you would like to use our mail-order pharmacy, call 1-800-548-9809 or order online at kp.org/refill. Definitions The following terms, when used in this "Outpatient Prescription Drug Rider" and in the Medical Benefits Chart mean: • Brand-Name Drug ("brand"). The first approved version of a drug. Marketed and sold under a proprietary, trademark-protected name by the pharmaceutical company that holds the original patent. • Generic Drug ("generic"). A drug that contains the same active ingredient as a brand-name drug and is approved by the U.S. Food and Drug Administration (FDA) as being therapeutically equivalent and having the same active ingredients(s) as the brand-name drug. Generally, generic drugs cost less than brand-name drugs, and must be identical in strength, safety, purity, and effectiveness. • Nonpreferred Brand-Name Drug. A brand-name drug or supply that is not approved by Health Plan’s Regional Formulary and Therapeutics Committee and requires prior authorization for coverage. • Preferred Brand-Name Drug. A brand-name drug or supply that Health Plan’s Regional Formulary and Therapeutics Committee has approved. Marketed and sold under a proprietary, trademark-protected name by the pharmaceutical company that holds the original patent. • Specialty Drug. A drug or supply, including many self-injectables as well as other medications, often used to treat complex chronic health conditions, is generally high cost, and is approved by the U.S. Food and Drug Administration (FDA). Specialty drug treatments often require specialized delivery, handling, monitoring, and administration. About our drug formulary Our drug formulary is a list of drugs that our Regional Formulary and Therapeutics Committee has reviewed and approved for our members and includes drugs covered un der this rider. Drugs on the formulary have been approved by the FDA. Our Regional Formulary and Therapeutics Committee is made up of network physicians, other network providers including pharmacists, and administrative staff. The committee chooses drugs for the formulary based on several factors, including safety and effectiveness as determined from a review of the scientific literature. They may not approve a drug if there is not enough scientific evidence that it is clinically effective. They may also exclude a drug if it does not have a clinical or cost advantage over comparable formulary drugs. RSARX0124 2