Common use of Generic Drugs Clause in Contracts

Generic Drugs. Drugs that (1) are approved by the Food and Drug Administration (FDA) as a therapeutic equivalent to the Brand Name Drug, (2) contain the same active ingredient as the Brand Name Drug, and (3) cost less than the Formulary Brand Name Drug equivalent. Home Self-Administered Injectables - Home Self- Administered Injectable medications are defined as those Drugs that are Medically Necessary; administered more often than once a month by the patient or family mem- ber; administered subcutaneously or intramuscularly; deemed safe for self-administration as determined by Blue Shield of California’s Pharmacy and Therapeutics Committee; prior authorized by Blue Shield of Califor- nia; and obtained from a Blue Shield of California Spe- cialty Pharmacy. Intravenous (IV) medications (i.e. those medications administered directly into a vein) are not considered Home Self-Administered Injectable drugs. Home Self-Administered Injectables are listed in Blue Shield’s Drug Formulary. Non-Formulary Drugs — Drugs determined by the Blue Shield Pharmacy and Therapeutics Committee as being duplicative or as having preferred Formulary Drugs alternatives available. Benefits are provided for Non-Formulary Drugs and are always subject to the Non-Formulary Copayment. Non-Participating Pharmacy — a pharmacy which does not participate in the Blue Shield of California Pharmacy Network. Participating Pharmacy — a pharmacy that participates in the Blue Shield Pharmacy Network. These Participat- ing Pharmacies have agreed to a contracted rate for cov- ered prescriptions for Blue Shield Subscribers and De- pendents. To select a Participating Pharmacy, the Subscriber may access this information at xxxx://xxx.xxxxxxxxxxxx.xxx or call the toll-free Member Services telephone number on their Blue Shield of California Identification Card. Specialty Pharmacy Network – select Participating Pharmacies contracted by Blue Shield of California to provide covered Home Self-Administered Injectables. These pharmacies offer 24-hour clinical services and provide prompt home delivery of Home Self- Administered Injectables. To select a Specialty Pharmacy, the Subscriber may ac- cess this information at xxxx://xxx.xxxxxxxxxxxx.xxx or call the toll-free Member Services telephone number on their Blue Shield of California Identification Card.

Generic Drugs. Drugs that (1) are approved by the Food and Drug Administration (FDA) as a therapeutic equivalent to the Brand Name Drug, (2) contain the same active ingredient as the Brand Name Drug, and (3) cost less than the Formulary Brand Name Drug equivalent. Home Self-Administered Injectables - – Home Self- Administered Injectable medications are defined as those Drugs that are Medically Necessary; administered more often than once a month by the patient or family mem- ber; administered subcutaneously or intramuscularly; deemed safe for self-administration as determined by Blue Shield of California’s Pharmacy and Therapeutics Committee; prior authorized by Blue Shield of Califor- nia; and obtained from a Blue Shield of California Spe- cialty Pharmacy. Intravenous (IV) medications (i.e. those medications administered directly into a vein) are not considered Home Self-Administered Injectable drugs. Home Self-Administered Injectables are listed in Blue Shield’s Drug Formulary. Non-Formulary Drugs — Drugs determined by the Blue Shield Pharmacy and Therapeutics Committee as being duplicative or as having preferred Formulary Drugs alternatives available. Benefits are provided for Non-Formulary Drugs and are always subject to the Non-Formulary Copayment. Non-Participating Pharmacy — a pharmacy which does not participate in the Blue Shield of California Pharmacy Network. Participating Pharmacy — a pharmacy that participates in the Blue Shield Pharmacy Network. These Participat- ing Pharmacies have agreed to a contracted rate for cov- ered prescriptions for Blue Shield Subscribers and De- pendents. To select a Participating Pharmacy, the Subscriber may access this information at xxxx://xxx.xxxxxxxxxxxx.xxx or call the toll-free Member Services Customer Service telephone number on their Blue Shield of California Identification Card. Specialty Pharmacy Network – select Participating Pharmacies contracted by Blue Shield of California to provide covered Home Self-Administered Injectables. These pharmacies offer 24-hour clinical services and provide prompt home delivery of Home Self- Administered Injectables. To select a Specialty Pharmacy, the Subscriber may ac- cess this information at xxxx://xxx.xxxxxxxxxxxx.xxx or call the toll-free Member Services Customer Service telephone number on their Blue Shield of California Identification Card.

Generic Drugs. Drugs that (1) are approved by the Food and Drug Administration (FDA) as a therapeutic equivalent to the Brand Name Drug, (2) contain the same active ingredient as the Brand Name Drug, and (3) cost less than the Formulary Brand Name Drug equivalent. Home Self-Administered Injectables - Home Self- Administered Injectable medications are defined as those Drugs that are Medically Necessary; administered more often than once a month by the patient or family mem- ber; administered subcutaneously or intramuscularly; deemed safe for self-administration as determined by Blue Shield of California’s Pharmacy and Therapeutics Committee; prior authorized by Blue Shield of Califor- nia; and obtained from a Blue Shield of California Spe- cialty Pharmacy. Intravenous (IV) medications (i.e. those medications administered directly into a vein) are not considered Home Self-Administered Injectable drugs. Home Self-Administered Injectables are listed in Blue Shield’s Drug Formulary. Non-Formulary Drugs — Drugs determined by the Blue Shield Shield’s Pharmacy and Therapeutics Committee as being duplicative du- plicative or as having preferred Formulary Drugs Drug alternatives available. Benefits are may be provided for Non-Formulary Drugs and are always subject to the Non-Formulary CopaymentCopay- ment. Non-Participating Pharmacy — a pharmacy which does not participate in the Blue Shield of California Pharmacy Network. Participating Pharmacy — a pharmacy that which participates in the Blue Shield Pharmacy Network. These Participat- ing Participating Pharmacies have agreed to a contracted rate for cov- ered covered prescriptions for Blue Shield Subscribers and De- pendentsMembers. Note: The Mail Service Pharmacy is a Par- ticipating Pharmacy. To select a Participating Pharmacy, the Subscriber you may access this information at go to xxxx://xxx.xxxxxxxxxxxx.xxx or call the toll-free Member Services telephone number on their your Blue Shield of California Identification Card. Specialty Drugs — Specialty Drugs are specific Drugs used to treat complex or chronic conditions which usually require close monitoring such as multiple sclerosis, hepatitis, rheuma- toid arthritis, cancer, and other conditions that are difficult to treat with traditional therapies. Specialty Drugs are listed in Blue Shield’s Outpatient Drug Formulary. Specialty Drugs may be self-administered in the home by injection by the pa- tient or family member (subcutaneously or intramuscularly), by inhalation, orally or topically. Infused or Intravenous (IV) medications are not included as Specialty Drugs. These Drugs may also require special handling, special manufactur- ing processes, and may have limited prescribing or limited pharmacy availability. Specialty Drugs must be considered safe for self-administration by Blue Shield’s Pharmacy and Therapeutics Committee, be obtained from a Blue Shield Spe- cialty Pharmacy and may require prior authorization for Med- ical Necessity by Blue Shield. Specialty Pharmacy Network – — select Participating Pharmacies Pharma- cies contracted by Blue Shield of California to provide covered Home Self-Administered InjectablesSpecialty Drugs. These pharmacies offer 24-hour clinical services and provide pro- vide prompt home delivery of Home Self- Administered InjectablesSpecialty Drugs. To select a Specialty Pharmacy, the Subscriber you may ac- cess this information at go to xxxx://xxx.xxxxxxxxxxxx.xxx or call the toll-free Member Services telephone number on their your Blue Shield of California Identification Card.

Generic Drugs. Drugs that (1) are approved by the Food and Drug Administration (FDA) as a therapeutic and equivalent to the Brand Name Drug, (2) contain the same active ingredient as the Brand Name Drug, and (3) cost less than the Formulary Brand Name Drug equivalentequiva- lent. Home Self-Administered Injectables - – Home Self- Administered Injectable medications are defined as those Drugs that are Medically Necessary; administered more often than once a month by the patient or family mem- ber; administered subcutaneously or intramuscularly; deemed safe for self-administration as determined by Blue Shield of California’s Pharmacy and Therapeutics Committee; prior authorized by Blue Shield of Califor- nia; and obtained from a Blue Shield of California Spe- cialty Pharmacy. Intravenous (IV) medications (i.e. those medications administered directly into a vein) are not considered Home Self-Administered Injectable drugs. Home Self-Administered Injectables are listed in Blue Shield’s Shield Drug Formulary. Non-Formulary Drugs — Drugs determined by the Blue Shield Shield’s Pharmacy and Therapeutics Committee as being duplicative or as having preferred Formulary Drugs alternatives available. Benefits are provided for Non-Formulary Drugs and are always subject to the Non-Formulary Copayment. Non-Participating Pharmacy — a pharmacy which does not participate in the Blue Shield of California Pharmacy Network. Participating Pharmacy — a pharmacy that participates in the Blue Shield of California Pharmacy Network. These Participat- ing Participating Pharmacies have agreed to a contracted con- tracted rate for cov- ered covered prescriptions for Blue Shield Subscribers and De- pendentsDependents. To select a Participating Pharmacy, the Subscriber may access this information at xxxx://xxx.xxxxxxxxxxxx.xxx or call the toll-free Member Services telephone number on their Blue Shield of California Identification Card. Specialty Pharmacy Network – select Participating Pharmacies contracted by Blue Shield of California to provide covered Home Self-Administered Injectables. These pharmacies offer 24-hour clinical services and provide prompt home delivery of Home Self- Administered Injectables. To select a Specialty Pharmacy, the Subscriber may ac- cess this information at xxxx://xxx.xxxxxxxxxxxx.xxx or call the toll-free Member Services telephone number on their Blue Shield of California Identification CardID card.