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Welcome to the High-Value Prescription Benefit Plan

At CVS/caremark, our goal is to help you take care of your health. We realize the medicines you need to do so can be costly. The good news is our team of doctors and pharmacists have created a high-value prescription benefit plan with medicines that can provide great health benefits and are priced right.*

With the high-value prescription plan, you can support your health and may save money, too.

Better Health, Better Value
What makes a prescription benefit plan “high-value”?
A plan is “high-value” because:
  • Many medicines included on the plan provide the same great health benefits as more expensive options, but may cost up to 80 percent less**
  • Medicines that cost more, but may not work better than lower-cost options, are not included or are included at up to the full cost, depending on your plan*
  • It can help you and your doctor choose a lower-cost—and just as effective—option to treat your health condition
What does the high-value plan mean for you?
In many cases, having the high-value plan means you will pay less out-of-pocket costs for plan medicines than you did with your previous plan. You may also have lower premiums each pay period, depending on your plan sponsor. With the high-value plan, you will have access to the medicines you need, and may even pay less for them. Do you have questions about the high-value plan? Read our Member Frequently Asked Questions
Facts about high-value plan medicines

Not sure if changing prescription benefit plans, or changing your medicine to a lower-cost option on the high-value plan, is right for you? These facts may help you decide:

  • Just because a medicine costs more does not mean it will work better
  • For many people, high-value medicines work just as well as higher-cost options**
  • Many medicines offered with the high-value plan are no longer “branded”, so manufacturers can produce “generic” versions for a fraction of the original cost
  • “Generic” does not mean lower quality or not effective

Keep reading to learn more about generic medicines. To see which medicines are offered with the high-value plan, view the Drug List.  
Questions and Answers about Generic Medicines

Q:  What are generic medicines?

A:  Generic medicines are versions of brand-name medicines that no longer have a patent. A patent protects the company that created the brand-name medicine so no one else can make or sell the product.

Q:  Are generic medicines as effective as brand-name medicines?

A:  Yes. The U.S. Food and Drug Administration (FDA) require generic medicines to have the same high quality, strength, purity, and stability as brand-name medicines.

A generic medicine is the same as the brand-name medicine in:

  • Dosage form
  • Safety
  • Strength
  • Quality
  • The way it works
  • The way you take it
  • The way you should use it

Q:  Why do generic medicines usually cost less?

A:  The research, development and marketing of new medicines cost a lot of money. Companies that make generic medicines do not have to develop them from scratch, so it usually costs much less to make. Generic medicine makers then pass the savings on to consumers.

Lower cost does not mean lower quality. Companies that make generic medicine have to show that their product performs the same as the brand-name.

Q:  How are generic medicines approved by the FDA?

A:  All generics must meet the same FDA standards as brand-names. To obtain approval, a generic medicine must:

  • Have the same active ingredient(s) as the brand name; the inactive ingredients may be different
  • Have the same strength and dosage form
  • Be taken the same way
  • Be used to treat the same health conditions
  • Be bioequivalent; this means the active ingredient in the generic medicine enters the body at the same speed and reaches the same levels in the body as the brand-name medicine
  • Meet the same standards for identity, strength, purity, and quality as the brand-name
  • Be made under the same strict guidelines the FDA requires for the brand name

Q:  Is generic medicine right for me?

A:  Today, there are many generic medicine options to treat many short and long-term health conditions. It makes sense to try a generic medicine because for many people, they work just as well as higher-cost, brand-name medicine but can help you save money. Why pay more to stay healthy than you have to?

Ask your doctor which generic medicines are right for you.

 


*Plan’s medicine list covers all disease states. Lifestyle-related treatments (i.e., anti-obesity, cosmetic, erectile dysfunction, and fertility agents) may not be included. Plan is limited to generic medicines and some brand-names when a generic is not available in the class. Coverage may vary, please consult your plan for further information.

**Savings will vary based on plan limitation and/or drug prescribed. Source: Generic Pharmaceutical Association Website: http://www.gphaonline.org/about/generic-medicines.

†Based on average prescription benefit plan. Features may or may not be applicable across all available prescription benefit plans.

‡ Out-of-pocket costs are copayment, copay or coinsurance which means the amount a plan member is required to pay for a prescription in accordance with a plan, which may be a deductible, a percentage of the prescription price, a fixed amount or other charge, with the balance, if any, paid by a plan

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