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Copay coinsurance for the first fill of select generic medications when filled at retail pharmacies. METHODS: This generic sample program involves 15 generic medications, including several antidepressants, nonsteroidal anti-inflammatories, and gastrointestinal medications. Two such medications, ranitidine and famotidine, are always adjudicated with a zero copay. Classes were chosen that had high member utilization and in which there were costly branded alternatives. Prior to implementation, several medications, including fluoxetine, had experienced a decrease in utilization. One possible reason for this trend is the lack of samples of generic medications in providers' offices. The program has been promoted to physicians through direct mailings, quarterly provider newsletters, wallcards, and physician detailing. It has been promoted to members through a member quarterly newsletter, employer broker meetings, health fairs, and pharmacy handbook language. The pharmacy department worked with sales and marketing, provider relations, broker relations, etc., in order to gain visibility and promote acceptance. Claims were analyzed starting July 1, 2003, through December 31, 2005, in order to determine use of the program, change in generic utilization, and cost savings. RESULTS: More than 152, 000 members 30% of the total heath plan members who filled a prescription during the time period ; participated in the generic sample program, filling more than 245, 700 prescriptions at a zero copay. The health plan's percentage of generic utilization across all classes increased incrementally, measured each quarter, resulting in a total increase of 10.7% since program inception. This increase of generic utilization is associated with approximately million in cost savings since July 1, 2003. The financial impact to the health plan due to lost copays was approximately million; resulting in a net savings to the plan of million over two and one-half years. CONCLUSION: Implementing the generic sample program has been a useful tool to remind physicians and members about generic options within therapeutic classes that have branded alternatives. As more generics become available, it may be prudent for health plans to assess the benefit of implementing a similar program and or generic step therapies within their pharmacy benefit. ss IMPACT OF PRESCRIBER EDUCATION ON UTILIZATION OF MEDICATIONS WITH HIGH ABUSE POTENTIAL IN A HIGH-RISK MANAGED CARE PLAN Thaker DJ * , O'Neill JM, Schultz LJ, Yokoyama KK. WellPoint Pharmacy Management, 8407 Fallbrook Ave., MS AF-7, West Hills, CA 91304; devi.thaker wellpoint , 818 ; 313-5072 OBJECTIVE: To evaluate the impact of an ongoing pharmacydriven intervention designed to promote safe and appropriate utilization of medications with high abuse potential. METHODS: This program was implemented in January 2004 in a health insurance plan serving high-risk individuals risk pool. Blower S, MaLi, Farmer P, Koenig S. Predicting the impact of antiretrovirals in resourcepoor settings: preventing HIV infections whilst controlling drug resistance. Infect Disorders. 2003; 3: 345-53.

Extensive and left-sided ulcerative colitis. Gastroenterology 1996; 110: 17138. Farthing JJ, Rutland JD, Clar JL. Retrograde spread of hydrocortisone-containing foam given intrarectally in ulcerative colitis. Br Med J 1979; 2: 18227. Jay M. Retrograde spreading of hydrocortisone enema in inflammatory bowel disease. Dig Dis Sci 1986; 31: 13944. Chapman NJ. Distribution of mesalamine enemas in patients with active distal ulcerative colitis. Mayo Clin Proc 1992; 67: 2458. Williams CN, Haber G, Aquino JA. Double-blind, placebocontrolled evaluation of 5-ASA suppositories in active distal proctitis and measurement of extent of spreading using TC-labeled 5-ASA suppositories. Dig Dis Sci 1987; 32: 71555. Safdi M, DeMicco M, Sninsky C, et al. A double-blind comparison of oral versus rectal mesalamine versus combination therapy in the treatment of distal ulcerative colitis. J Gastroenterol 1997; 92: 186771. Hanauer S, Good LI, Goodman MW, et al. Long term use of mesalazine Rowasa ; suppositories in remission maintenance of ulcerative proctitis. J Gastroenterol 2000; 95: 174954. D'Albasio G, Paoluzi P, Campieri M, et al. Maintenance treatment of ulcerative proctitis with mesalazine suppositories: A double-blind placebo-controlled trial. J Gastroenterol 1998; 93: 799803. Kruis W, Schreiber S, Theuer D, et al. Low dose balsalazide 1.5 g twice daily ; and mesalazine 0.5 g three times daily ; maintained remission of ulcerative colitis but high dose balsalazide 3.0 g twice daily ; was superior in preventing relapses. Gut 2001; 49: 7839. Green JRB, Gibson JA, Kerr GD, et al. Maintenance of remission of ulcerative colitis: A comparison between balsalazide 3 g daily and mesalazine 1.2 g daily over 12 months. Aliment Pharmacol Ther 1998; 12: 120716. D'Albasio G, Pacini F, Camarri E, et al. Combined therapy with 5-aminosalicylic acid tablets and enemas for maintaining remission in ulcerative colitis: A randomized double-blind study. J Gastroenterol 1992; 1997: 1143 Lindgren S, Suhr O, Persson T, et al. Treatment of active distal ulcerative colitis and maintenance of remission with Entercort enema: A randomized controlled dosage study. Gut 1997; 41: A223. Hanauer SB, Schwartz J, Robinson M, et al. Mesalamine capsules Pentasa ; for treatment of active ulcerative colitis: Results of a controlled trial. J Gastroenterol 1993; 88: 118897. Willoughby CP, Cowan RE, Gould SR. Double-blind comparison of olsalazine and sulfasalazine in active ulcerative colitis. Scand J Gastroenterol Suppl 1988; 148: 404. Sandborn WJ, Tremaine WJ, Offord KP, et al. Transdermal nicotine for mildly to moderately active ulcerative colitis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1997; 126: 36471. Pullan RD, Rhodes J, Ganesh S. Transdermal nicotine for active ulcerative colitis. N Engl J Med 1994; 330: 8115. Sandborn WJ. Nicotine therapy for ulcerative colitis: A review of rationale, mechanisms, pharmacology, and clinical results. J Gastroenterol 1999; 94: 116171. Thomas GAO, Rhodes J, Mani V, et al. Transdermal nicotine as maintenance therapy for ulcerative colitis. N Engl J Med 1995; 332: 98892. Truelove SC, Witts IJ. Cortisone in ulcerative colitis: Report on a therapeutic trial. Br Med J 2: 10419. Lennard-Jones JE. An assessment of prednisone, salazopy.

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