Advanced Control Specialty Drug List

Frequently Asked Questions

  • Why is the formulary changing?

    Your plan sponsor asks that CVS/caremark monitor brand-name drugs that may have lower-cost options available. This helps save both you and your plan sponsor money throughout the year. CVS/caremark is committed to helping you get the most effective medications at the best price and keeping access to prescription drugs affordable.

  • Why is my drug no longer on the formulary?

    There are often multiple drugs available to treat the same condition—either a generic drug, brand-name drug or both. These options have shown to be effective and safe, and they may help you save money on your prescriptions. Our pharmacy staff has determined that your drug has these types of options available.

  • If I have more than one option, how do I decide?

    The best step is to talk to your doctor about the formulary options soon, and before your current drug is no longer on the formulary.

  • How much will I save when I change to a formulary drug?

    You can view the exact price you will pay for your drugs by logging on to Caremark.com, and select “Check Drug Cost.” Remember—the savings really add up if you are taking a long-term medication for months or years at a time.

  • Do I have to change my drug?

    No, you always have the choice of continuing with your current medication. If you choose to remain on your current medication, you may use any retail pharmacy and should expect to pay the full cost of those prescriptions.

  • My other medications are not listed here. Will they still be covered?

    Yes, this formulary change only affects a small number of medications. Review your benefit plan to make sure there are no other specific coverage rules for your other medications.

  • What if my doctor wants me to stay on my current drug?

    Your doctor always has the final decision on what medication is right for your condition. Remind your doctor that your benefit plan no longer covers this medication, and you will have to pay full price. If your doctor thinks there is a clinical reason why one of these covered specialty options won’t work for you, your doctor can call us toll-free at 1-866-814-5506 to request approval for your current medicine(s).

  • Where do I go to get my prescription filled with the new drug?

    Once you and your doctor have agreed on the new drug option, ask your doctor to call in the new prescription or take it to a pharmacy in the CVS/caremark network.

    To get started with CVS Caremark Specialty Pharmacy: Your doctor can call in the new prescription to us toll-free at 1-800-237-2767. Or you can call us toll-free at 1-800-237-2767, and we will contact your doctor for you.