Winter 2024

Winter…the dreaded cold and flu season. It can be especially difficult to maintain your health and well-being during the winter months. Shorter days and longer nights give way to more time spent indoors and increased exposure to germs.

Understanding the signs and symptoms of a cold or flu are important to keeping yourself and others safe and healthy this season. Although the cold and flu are often used synonymously, there are certain symptoms that differentiate the two. While both a cold and flu often come with the quintessential coughing, sneezing, congestion and aches, flu symptoms may present more severely and are often accompanied by a fever. As always, if you begin to feel any cold or flu-like symptoms, you should distance yourself from others and contact your health care provider.

Don’t wait until you’re already feeling under the weather to prioritize your winter wellness, though! There are a number of proactive steps you can take to keep you and your loved ones healthy throughout the winter and beyond.

1. Wash your hands. Regular handwashing prevents the spread of germs and reduces the risk of infection. Wash your hands frequently with soap and water, scrubbing for at least 20 seconds. According to the Centers for Disease Control and Prevention (CDC), if soap and water are not readily available, hand sanitizer with at least 60% alcohol can be used to effectively clean your hands.
2. Eat a balanced diet. Eating nutritious foods helps to support the immune system. Incorporating foods that are rich in vitamins, minerals and antioxidants contribute to your overall health and may help prevent or treat a cold or flu.
3. Get enough sleep. Sleep reduces feelings of stress and fatigue, both of which can weaken the immune system. Getting an adequate amount of sleep is critical to the body’s ability to fight infection.
4. Disinfect commonly used surfaces. Properly disinfecting high-traffic surfaces is an important step in limiting the transmission of germs. To disinfect hard surfaces, first clean the surface with hot, soapy water then apply a registered disinfectant or stronger bleach solution. Use disinfecting products cautiously and follow the directions on the label to ensure safe and effective application.
5. Take vitamins and supplements. Give your immune system a boost with vitamins and supplements such as Vitamin C and D to help fight infections and Zinc to reduce inflammation.  As some products may interact with prescription medications, talk with your doctor or pharmacist to see which vitamins and supplements are safe and beneficial for you.

Research has established that regular exercise delivers benefits for both your physical and mental health. While it may be more convenient to step outdoors for a quick walk or an intense workout class during the warmer months, the benefits of physical activity are just as great (if not greater!) during winter.

As tempting as it may be to cozy up by the fireplace all winter long, we encourage you to commit yourself to regular physical activity. According to the CDC, healthy adults need 150 minutes of moderate-intensity physical activity each week. Whether it’s a trip to the gym, an indoor yoga class, or embracing the season with a wintery nature walk, snowshoeing or even shoveling, staying physically active pays dividends toward your overall health. However, individuals with chronic conditions such as heart problems, arthritis, or diabetes should first consult their doctor about the right types and amounts of physical activity to engage in.

Regular exercise leads to better sleep, reduced anxiety, and a lower risk of many diseases. In fact, emerging research suggests that physical activity can even help strengthen your immune system, which could have a significant impact on your well-being during the dark winter months.

In addition to local fitness centers or the great outdoors, there are countless online tools, videos and apps that provide free or low-cost tutorials to help you get moving this winter. The transition from sweaty outdoor workouts to creative indoor exercise can be simplified through the use of common household items such as your staircase, a one-gallon jug, or a backpack filled with books for weight. No matter the type of activity you choose, always use caution and be mindful of duration and intensity to limit the risk of exercise-related injury.  

Physical activity is an important aspect of your overall health and well-being. No matter where or how you do it, prioritizing safe and effective exercise is sure to help you survive and thrive this winter season. 

The creation of your prescription drug formulary is an essential function of our role as your pharmacy benefit manager. A prescription drug formulary is defined as a master list of prescription drugs that are covered by your health plan. The drugs on this list are guided by your health plan requirements and carefully evaluated by our Pharmacy and Therapeutics (P&T) Committee.

Pharmacy Benefit Dimensions’ P&T Committee is comprised of 14 participating physicians and 4 network pharmacists who meet quarterly to thoroughly review the drug formulary as well as any new drugs – brand or generic – that have been made available. Committee members are independent clinicians, and their identities remain confidential to eliminate any bias or undue pressure.

During their quarterly review, the P&T Committee will recommend additions, deletions and modifications to your prescription drug formulary based on sound clinical evidence. Decisions made by the committee are determined by efficacy and safety first, and economic value only after clinical effectiveness has been established.

Here are changes to the Pharmacy Benefit Dimensions drug formulary that were recommended by the P&T Committee at its November 2023 meeting:

The following medications were added to the formulary:

The following changes were/will be made to the formulary:

• carbidopa 25mg – move from tier 3 to tier 1
• metaxalone 400mg tablet – move from tier 3 to non-formulary
• metaxalone 800mg tablet – move from tier 3 to tier 1
• orphenadrine ER tablet – add to tier 1
• Pentasa® 500mg tablets – add to PB
• Pheburane® oral pellets - add to NPB, PA, SP
• pyridostigmine oral solution - add to tier 1
• rasagiline tablets – remove PA
• Ravicti® – move from NPB, PA, SP to non-formulary
• Revlimid® (brand) – move from PB, PA, SP to non-formulary
• Zelapar® ODT – move from NPB, PA to non-formulary 

The following new generic medications are available:

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

• Cabtreo®
• Coxanto®
• Exxua® ER
• Entyvio® SQ
• glipizide 2.5mg
• Likmez®              
• Omvoh® SQ
• Ozobax® DS
• Qlosi®
• Ryzumvi®
• trientine 500mg
• Wezlana® SQ
• Zymfentra®

The following medications were reviewed and will be covered as a medical benefit:

• Adzynma® - PA, SP
• Aphexda® - PA, SP
• Cosentyx® IV - PA, SP
• Daxxify® - PA
• Eylea HD® - PA, SP
• Focinvez® - PA
• Hepzato®
• Ixchiq®
• Loqtorzi® - PA, SP
• Omvoh® IV – PA, SP
• Opfolda® - PA, SP
• Penbraya® - AL
• Pombiliti® - PA, SP
• Tofidence® - PA, SP
• Tyruko® - PA, SP
• Veopoz® IV/SQ – PA, SP
• Wezlana® IV - PA, SP

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.

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