Dimensions Newsletter | Summer 2025

October is Health Literacy Month

Health literacy is more than just understanding medical terms — it’s the ability to find, comprehend, and use health information effectively to navigate the health care system, communicate with your doctors and pharmacists, and manage your family’s well-being.

How We Can Help

At Pharmacy Benefit Dimensions (PBDRx), we recognize that clear, accurate and accessible health information is essential for our members to take charge of their health. During Health Literacy Month, we are reaffirming our commitment to providing resources that are not only informative and reliable, but also actionable and easy to understand.

We’re here to answer questions, helping you to:

• Learn how to use your pharmacy benefits
• Understand what drugs are covered by your plan (your formulary)
• Figure out how much medications cost at different pharmacies

What is a Formulary?

All new and existing drugs on our drug formulary (a list of your covered medications) are reviewed quarterly by the Pharmacy & Therapeutics (P&T) Committee for safety, efficacy and cost. Certain drugs on the PBDRx drug formulary require prior authorization or step therapy with a generic medication prior to coverage. This helps us to ensure that you get the best quality and value from your prescription drug benefit and that the right drug is available to you.

Part of your benefit is access to a team of expert clinical pharmacists in place who work closely with providers and review prior authorization requests to ensure that clinical criteria or medical necessity are met. Our clinical team helps you navigate the prior authorization process and may also make clinical recommendations based on therapeutic guidelines and best practices.

By improving your health literacy, we aim to reduce confusion, improve health outcomes, and empower you to make choices that lead to healthier lives.

Some of the things we are doing at PBDRx behind the scenes:

• Simplifying Our Communications: Using plain language and visuals in our member communications.
• Offering Personalized Support: Using data to identify members who may need extra help and reach out with tailored education and resources.
• Promoting Generic Substitutions: Educating members about the safety and affordability of generic medications to improve adherence and reduce costs.

Ways to Learn and Understand Better

Individuals with more knowledge about their health are better equipped to manage chronic conditions, follow treatment plans and prevent diseases. Understanding your pharmacy benefits can help you save money, avoid medication errors, and improve your health outcomes. Here are some practical ways to get started:

• Ask Questions at the Pharmacy: Don’t hesitate to ask your pharmacist about your medications, costs, or alternatives. They’re one of the most accessible health care professionals.
• Explore Digital Tools: PBDRx has a member portal where you can track prescriptions, compare drug prices, and understand your coverage.
• Practice the “Teach-Back” Method: After receiving instructions, repeat them back to your pharmacist to confirm you’ve understood everything correctly.
• Attend Educational Programs: Some pharmacies offer workshops or counseling sessions to help you manage chronic conditions and understand your benefits.

Prescription medications can help you maintain your health and manage chronic conditions, but can also be very expensive. Even with prescription coverage through PBDRx, your monthly costs can add up quickly. Here are a few ideas to help you keep your prescription costs in check.

1. SPEAK WITH YOUR DOCTOR: If you are unsure about a medication you are taking or don’t think it is working for you, be sure to let your doctor know. Keeping your doctor informed is key to ensuring you receive the most appropriate, effective care. And if something isn’t working for you, he or she may be able to recommend an alternative course of action, which could save you money.
2. USE GENERIC DRUGS: Many brand name drugs have generic alternatives that are as safe and effective as the brand name but at a lower cost. Even drugs that do not have a direct generic alternative may be in a class of drugs that do. For example, there are several generic medications that lower cholesterol that can be used instead of higher priced brand name drugs. Ask your doctor about alternative medications and check if they’re covered by your health plan.
3. ASK ABOUT TABLET SPLITTING: Some medications with different strengths cost the same: one lower strength tablet costs the same as the higher strength dose. By splitting the higher strength tablet in half, you will get two doses for the price of one, saving you money. Not all medications should be split in half. Check with your doctor or health plan.
4. TRY AN OVER-THE-COUNTER MEDICATION: Several drugs that used to be available by prescription have been approved by the Food and Drug Administration to be sold over the counter. Sometimes, they cost less.
5. MAKE LIFESTYLE CHANGES: Eating healthy and exercising on a regular basis may delay the need for medication for some conditions (e.g., high cholesterol, hypertension, diabetes, acid reflux, etc.), as well as help the medication you are on work more effectively.

Talk with your doctor about what lifestyle changes you can make. As always, please check with your health care provider about your medication needs.

PBDRx also provides 5-Star customer service. If you have questions about your medications or benefits, our Member Services Department is available to assist you. Please call (716) 635-7880 or 1-888-878-9172, Monday through Friday from 8 a.m. to 11 p.m. ET. TTY users please call 711.

Here are the quarterly changes to the Pharmacy Benefit Dimensions drug formulary.

The following medications will be added to the formulary:

The following new generic medications are available:

The following medications were reviewed and will remain non-formulary:

• Tryptyr® ophthalmic solution
• Vizz® ophthalmic solution
• Brinsupri® tablets
• Tonmya® sublingual tablets
• Anzupgo® topical cream
• Ekterly® tablets
• Sephience® oral powder
• Harliku® tablets
• Starjemza® subcutaneous
• Kirsty® solution in vial and pen
• Brekiya® subcutaneous
• Yutrepia® powder for inhalation
• Khindivi® oral solution
• Widaplik® tablets
• Arynta® oral solution
• Vostally® oral solution
• Sdamlo® powder for oral solution
• Vyscoxa® oral solution
• Atmeksi® oral suspension
• Phyrago® tablets
• Ausuvar® tablets for oral suspension

Please reach out with any questions you may have. To best assist you, choose from the following:

Questions about your pharmacy benefits as a PBD member? Contact Member Services, 1-888-878-9172.

Questions about a claim from a pharmacy or provider? Contact our Pharmacy Help Desk, (716) 635-3578.

Questions about the benefits of partnering with PBD? Contact our Sales Department, (716) 860-0743.

Stay informed: pbdrx.com | LinkedIn | PBD News