Agreement - Blue Cross Blue Shield - Self Fund Medical Insurance for CIty Employees for 2019

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f prescription profile, including all home delivery, specialty and retail prescriptions processed through the prescription benefit plan. Pharmacy Gaps in Care Messaging programs, including'. � $0.25 per script Medication Review o Personalized member information related to pharmacy gaps in care including appropriate use, medication compliance, safety, cost savings on generics and formulary alternatives. o Select Cost -of -Care messages sent via a standalone communication: Generic Select: Members sent information on selected brand drugs where a generic is available and receive waived copay for first fill of Generic Select drug both at home delivery and retail. Half Tablet: Members sent information on selected drugs eligible for half of the copay when they fill half as many tablets at double the strength and cut the'tablets. Patient Highlights o Physicians receive personalized, actionable information related to appropriate use, medication compliance and safety to help address pharmacy related gaps in care. o Appropriate use and compliance programs focus on disease states such as asthma, COPD, depression, diabetes, high cholesterol and hypertension. o Safety programs including identification of polypharmacy and high - dose alerts. o Personalized, actionable information related to the members use of controlled substances. Prospective Drug Utilization Review programs Included Cost -of -Care programs: � Included o Formulary management — outcomes -based formulary Generic Drug Management: � Included o Preferred Generics — members pay brand copay plus the cost difference when a generic is available but a brand is selected o First -Time Generics — letters to members when there is a new (first - in -class) generic available in a therapeutic class Retail -to -Home Delivery member outreach programs Q Included Vaccine Program Fee R 1),oihng , er uC,'es $2.50 per vaccine claim