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considerations, Lockton recommends the County transition to Express Scripts as the PBM <br />effective May 1, 2018. Express Scripts would provide access to over 67,000 pharmacies <br />throughout the United States and includes all of the major pharmacies (Walgreens, CVS, <br />Walmart, Publix, Sam's Club, Kmart, Winn-Dixie) in Indian River County as well as thirteen (13) <br />independent pharmacies. The pharmacy benefit would be administered through RXBenefits, and <br />employees would have a separate pharmacy customer service line to obtain assistance with <br />questions related to the pharmacy benefit. <br />A transition to Express Scripts provides minimal disruption to members as reflected below: <br />During the six month period that was reviewed, 23,393 prescriptions were filled. When analyzing <br />the prescriptions under the Express Scripts formulary, there would be no disruption (neutral) to <br />94.45% of the prescriptions filled, and there would be a positive impact to 3.12% of the <br />prescriptions filled under our plan -- moving from tier 3 to tier 2 (reducing the copay from $50 to <br />$35). This means that 97.57% of the prescriptions filled under the plan over the six month period <br />would have either no disruption or have a positive impact. <br />The move to Express Scripts would have a negative impact on 2.42% of the prescriptions filled. <br />The medication would either move from tier 2 to tier 3 (increasing the copay from $35 to $50) or <br />move from a covered medicine to a non -covered medicine under the new formulary. If a <br />medication would no longer be covered under the new formulary, an alternate medication would <br />need to be prescribed. <br />Below is a listing of the top 10 drugs that would be excluded on the new Express Scripts formulary <br />and the alternative medication available under the new formulary. The majority of the <br />medications are diabetes medications. Lockton would work with the County to develop a <br />communication plan for members and address the impact of the negative disruption in advance <br />of the change so that members could make necessary medication changes. A 90 day <br />implementation period is recommended. Members currently using a blood glucose meter other <br />than the preferred brand for Express Scripts, will be provided a replacement by the manufacturer <br />at no cost. <br />V*_ <br />N., P,wded <br />45 <br />B,d� 1 B,—, T, l.d,, <br />N—LOG <br />Nor Provided <br />28 <br />!4,.r.rnoq <br />H. -LOG A '0 30 PLa Pen <br />Nd P.o.ded <br />2� <br />Hwndop <br />bad bch— Z_ <br />Nd P.—.id <br />20 <br />- b. <br />0,4n. <br />P -6d <br />l8 <br />la..ma, T,,do—. <br />To aeuw <br />r4. Prded <br />ovi <br />18 <br />B,dKeor., D,m , Truk,, <br />Pre.r+il HFA <br />N. Prded <br />11 <br />Pr Air IFA. Pepir7ih, Ve lm ffA <br />Abpip- 1 a-- <br />A. Prwwd•d <br />10 <br />la.y.d, Trpdow. <br />98 <br />