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ORX, Over-the-Counter by Prescription

White Paper

Coverage of OTC drugs under prescription drug benefits can help improve employee healthcare quality and reduce plan costs.

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What is ORx®

ORx® is a concept developed by Perrigo where pharmacy benefit coverage is extended to over-the-counter drugs dispensed by prescription. To encourage their use, medicines covered under an ORx® drug benefit are typically offered as Tier 1/Preferred drugs or in a separate OTC tier, with no co-payment or a lower co-pay than other prescription drugs.

Drugs offered within ORx® benefit plans usually include medicines formerly classified as prescription-only drugs but now reclassified by the FDA as safe for over-the-counter use.

Drugs covered by ORx® benefit plans must be assigned a national drug code (NDC) under the Human Prescription Drug classification. Perrigo's ORx products meet this requirement and are inventoried behind the pharmacy counter and dispensed by a pharmacist.

Benefits of ORx®

By including qualifying over-the-counter medications under prescription drug benefit plans, plan sponsors can:

  • Reduce drug costs for plan participants by offering proven medications in plan formularies as Tier 1/Preferred drugs or in a special OTC Tier, at low or no co-payment.
  • Reduce health plan costs by encouraging patients to consult a physician early for proper treatment, and encouraging doctors to prescribe lower-cost OTC drugs instead of more costly prescription-only remedies.
  • Encourage greater patient compliance with doctor prescribed therapies, which could help reduce the potential for complications and expensive hospital visits.
  • Enhance employee benefit packages, building goodwill by alleviating participant health and financial concerns while supporting valued employee recruitment and retention goals.

Getting Started with ORx®

The first step in designing ORx® coverage is to discuss the concept with your pharmacy benefit management (PBM) or other prescription drug benefit manager. The majority of PBMs surveyed in 2014 said they currently include coverage of OTC drugs in formularies when requested by plan sponsors.

As your ORx® benefit is defined, it will be important to confirm the availability of properly NDC-labeled products to all plan participants. View our online listing of ORx® drugs available from Perrigo.

For assistance in exploring our adoption of ORx® coverage and available Perrigo products to support your benefit plan, please contact us at PerrigoRx@perrigo.com.

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