From Our Partners
Darlene Kirkpatrick | Division Manager, Third Party and Spending Account Administration, ASEBP
Managing Your Medications
When it comes to managing prescription
medications — whether they’re your own or
you’re helping a loved one — things can get
complicated. At ARTA, we understand that
medication needs are as unique as each person.
From making sure new medications are added
for coverage at the right time, to ensuring
every member has fair and equal access to the
coverage they need — it’s important work that
we’re proud to offer to ARTA plan members.
While we have implemented a number of
medication management programs to help
make sure that your ARTA benefits provide the
best possible coverage now, and well into the
future, the two benefits we receive the most
questions about are Least Cost Alternatives
(LCA) and Therapeutic Alternative Reference
Pricing (TARP).
Least Cost Alternatives
Our LCA program, in which your ARTA benefits
pay for prescriptions up to the price of the
lowest cost medication for a specific drug, helps
us mitigate the risk posed by the wide range of
prices for similar medications. For example,
brand name Lipitor 80 mg costs $2.45 per pill
while Atorvastatin, a generic version of the same
medication, costs 23¢ per pill. So, while you are
still able to take Lipitor if that’s what you and
your physician prefer, your benefits will only
cover the cost of 23¢ per pill. As noted in the
following, all the medications identified as LCA
have the same active ingredients as their brand
name counterparts and are proven equally safe
and effective.
52 | arta.net
Therapeutic Alternative Reference Pricing
ARTA’s TARP program encourages cost-effective
prescribing for common medical conditions,
identifying ‘preferred’ medications to treat high
blood pressure, migraines, pain and inflammation
management (non-narcotic), and stomach
hyperacidity. All the medications identified
as preferred alternatives have similar active
ingredients to their higher cost counterparts and
are proven equally safe and effective.
If the medication you have been prescribed falls
into one of the program’s four categories and has
preferred alternatives, you have two options:
1. You can choose to start taking the preferred
drug instead of the one you were prescribed,
and you will be covered as you usually would
under your plan,
or
2. You can choose to take the medication you
were originally prescribed and pay for the
cost difference between the prescribed and
the preferred drug either out-of-pocket or
through your benefits with another
health-care provider.
Just like with the LCA program,
you decide what medication
to take.