Medication Synchronization Medication synchronization is the coordination of medication refills, if you are taking two or more medications for a chronic condition, so that your medications are refilled on the same schedule. You may request medication synchronization for a new prescription from the prescribing provider or a Participating Pharmacy who will determine the appropriateness of medication synchronization for the drugs being dispensed and inform you of the decision. If the prescription will be filled to more or less than the prescribed day supply limit for the purpose of medication synchronization, we will adjust the cost share accordingly. How to Get Covered Drugs or Supplies Participating pharmacies are located in many Participating Facilities. To find a Participating Pharmacy, please see your Medical Facility Directory, visit kp.org/directory/nw, or contact Member Services. Participating 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 Brand-Name Drug. 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. 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. Non-Preferred Brand-Name Drug. A Brand-Name drug or supply that is not approved by Kaiser’s Regional Formulary and Therapeutics Committee and requires prior authorization for coverage. Preferred Brand-Name Drug. A Brand-Name drug or supply that Kaiser’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. Preventive Drug. A drug on our preventive items list when prescribed to prevent the onset of disease or illness. If you would like a copy of the current list of eligible Preventive Drugs, please call Member Services. 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 under this section “Prescription drugs, insulin, and diabetic supplies.” Drugs on the Formulary have been approved by the FDA. Our Regional Formulary and Therapeutics Committee is made up of Participating Physicians, other Participating Providers, 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 EWCLGHDHP1983ACT0124 60 WAPEBB-CD-ACT
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