Therapeutic Alternative Reference Pricing

ASEBP’s Therapeutic Alternative Reference Pricing (TARP) program encourages cost-effective prescribing for four common medical conditions. The program identifies “preferred” drugs to treat the following:

• Stomach hyperacidity
• High blood pressure
• Pain/inflammation management (non-narcotic)
• Migraines

All the medications identified as preferred alternatives are proven to be equally safe and effective to their brand or generic counterparts. You can visit the Drug Inquiry Tool on My ASEBP to see if a drug you’ve been prescribed has preferred alternatives under the TARP program.

If the drug you’ve been prescribed falls into one of the four categories listed above and has preferred alternatives, you have two options:

1. You can choose to start taking the preferred drug instead of the one you were prescribed, and you’ll be covered as you would usually under your plan, or
2. You can choose to start taking or remain on the drug you were originally prescribed and pay for the cost difference between the prescribed and the preferred drug either out-of-pocket, through your benefits with another health care provider or through a spending account if you have access to one.

If you can’t take the preferred drug for medical reasons (e.g. you have an allergy), the doctor or other licensed health care provider who wrote the prescription can submit a special (pricing) authorization request on your behalf—they have easy access to the required form. If approved, this authorization will ensure you’re covered for the prescribed drug within the limits of your plan.

If you choose to remain on your prescribed drug, pay out-of-pocket for the difference, and then have your health care provider submit a special authorization to ASEBP for review afterward, understand that:

1. The submission of the authorization is not a guarantee of approval, and
2. If approved, the authorization takes effect on the first day of the month that your approval was granted and not the date you filled your prescription or made the claim.