This includes patients using steroids, with a prior history of gastrointestinal disease, and the elderly. Although the reduction of the incidence of ulcers is a positive benefit, many patients using Cox-2 inhibitors are not at risk for developing ulcers. In a Buy-Up program, the payor identifies preferred products in each therapeutic class. If the patient can prove a clinical need, the patient can receive the prescription for the usual copayment. In order to receive a Cox-2 prescription, the patients are required to pay a larger portion of the cost.
Many different mechanisms are available for managing the use of individual drugs.
Talk to your PBM about recommendations for managing Cox-2 inhibitors, as well as other therapeutic classes.