Aetna Better Health. Specialty Drug Program
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- Elwin Gilmore
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1 Aetna Better Health is managed through CVS Health Specialty Pharmacy. The Specialty pharmacies fill prescriptions and ship drugs for complex medical conditions, including multiple sclerosis, rheumatoid arthritis and most cancer drugs. Medications provided through CVS specialty pharmacy include injectable, oral and inhaled drugs. Due to the complexity of these drugs, they require a high level of support and care guidelines for shipment and storage. The provides care management services to your members, including: 24 hours a day, seven days a week access to a pharmacist Disease-specific education and counseling by the CareTeam TM. The CareTeam TM are clinical professionals who review dosing and medication schedules, identify injection issues, provide education of potential side effects and provide information to help your member to manage their medical condition. Care coordination with your member and you Delivery of Specialty drugs to your member s home and/or your office in temperaturecontrolled packaging with the required supplies, i.e. needles, syringes, and alcohol wipes Contact CVS Specialty Pharmacy at from 7:30 a.m. (EST) to 9:00 p.m. (EST) time, Monday Friday. CVS Specialty Pharmacy will assist you in filling your specialty drug. Prior Authorization (PA) still applies to specific specialty drugs that require a clinical review. You can check our health plan website at to confirm PA requirements on the below listed medications as well as review of the PA Guideline used in our clinical reviews. Last Update: 05/2017 Page 1
2 ALLERGEN IMMUNOTHERAPY Coagulation Disorders Cryopyrin Associated Periodic Syndromes Gastrointestinal Hematopoietics ORALAIR SAIZEN ARALAST NP GLASSIA ZEMAIRA CEPROTIN ILARIS GATTEX GENOTROPIN HUMATROPE INCRELEX NORDITROPIN NUTROPIN OMNITROPE SEROSTIM TEV-TROPIN ZORBTIVE MOZOBIL ADVATE ALPHANINE SD ALPHANATE ALPROLIX BEBULIN BENEFIX CORIFACT ELOCTATE FEIBA NF HELIXATE FS HEMOFIL M HUMATE-P KOATE-DVI MONOCLATE MONONINE NOVOSEVEN RT Last Update: 05/2017 Page 2
3 Hepatitis B Idiopathic Thrombocytopenic Purpura Idiopathic Thrombocytopenic Purpura Infectious Disease Iron Overload LIPID DISORDER PROFILNINE SD RECOMBINATE RIXUBIS TRETTEN WILATE XYNTHA XYNTHA SOLOFUSE BARACLUDE BERINERT CINRYZE FIRAZYR BIVIGAM CARIMUNE NF NANOFILTERED CYTOGAM FLEBOGAMMA GAMMAGARD LIQUID GAMMAKED HIZENTRA OCTAGAM PRIVIGEN GAMUNEX-C NPLATE PROMACTA ACTIMMUNE EXJADE KYNAMRO ALDURAZYME CEREZYME CYSTAGON ELAPRASE FABRAZYME LUMIZYME MYOZYME NAGLAZYME Last Update: 05/2017 Page 3
4 Movement disorders Neutropenia Neutropenia Oncology oral Oncology Oral Oncology-Oral VIMIZIM VPRIV Xenazine EXTAVIA MITOXANTRONE PLEGRIDY AUBAGIO GRANIX LEUKINE GAZYVA INTRON A ONCASPAR SYLATRON ERIVEDGE INLYTA JAKAFI MEKINIST NEXAVAR POMALYST REVLIMID STIVARGA SUTENT TAFINLAR THALOMID TYKERB VOTRIENT XALKORI ZELBORAF ZYKADIA ZYTIGA Afinitor Cabometyx TARGRETIN Brand Only ESBRIET HYQVIA RUCONEST SDV Last Update: 05/2017 Page 4
5 Paroxysmal Nocturnal Hemoglobinuria Phenylketonuria Psoriasis Psoriasis Rheumatoid Arthritis RSV Seizure disorder Urea Cycle Disorders SIRTURO SOLIRIS KUVAN OTEZLA STELARA ADEMPAS LETAIRIS ORENITRAM ORENITRAM ER REMODULIN TRACLEER TYVASO VELETRI VENTAVIS SIMPONI SYNAGIS Sabril RAVICTI Last Update: 05/2017 Page 5
RAHF PFM ALPHANINE SD COAGULATION FACTOR IX J7193 COAGULATION FACTOR IX (RFIXFC)
INFECTIOUS DISEASE ACTIMMUNE INTERFERON GAMMA 1B J9216 ADVATE RAHF PFM ONCOLOGY ORAL AFINITOR EVEROLIMUS J7527 INFECTIOUS DISEASE ALFERON N INTERFERON ALFA N3 J9215 ALPHANATE VWF J7186 ALPHANINE SD J7193
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