TABLE OF CONTENTS (Click on a link below to view the section.)

Similar documents
TABLE OF CONTENTS (Click on a link below to view the section.)

TABLE OF CONTENTS (Click on a link below to view the section.)

TABLE OF CONTENTS (Click on a link below to view the section.)

OHIO MEDICAID PHARMACY COVERAGE

Relative Cost/Month. Less than $10. Loratadine Liquid* $10-$15 Cetirizine liquid 1mg/mL*

Mercy Care Plan. Acyclovir Ointment. Products Affected. acyclovir ointment 5 % external Details. Criteria. Requires use of oral Acyclovir

Aetna Better Health of Illinois Medicaid Formulary Updates

Oregon Health Plan prescription benefit updates

Alameda Alliance for Health Pharmacy & Therapeutics (P&T) Committee Decisions

Mercy Care ALBENDAZOLE. Products Affected. ALBENZA TABLET 200 MG ORAL Details. Criteria. Refer to PA Guideline for approval criteria

ANTINEOPLASTIC DRUGS CHAPTER 21. Antineoplastic drugs - designed to treat malignancies, now also used to treat diseases with inflammatory component

AETNA BETTER HEALTH January 2017 Formulary Change(s)

Step Therapy Medications

AETNA BETTER HEALTH January 2017 Formulary Change(s)

CLINICAL MEDICAL POLICY

Step Therapy Requirements

CAMPER APPLICATION PACKET

Quarterly pharmacy formulary change notice

Acyclovir Ointment. Aetna Better Health Pennsylvania. Products Affected. acyclovir ointment 5 % external Details. Criteria

Drug Class Monograph

Diagnosis and Management of Asthma

Inhaled bronchodilators relax constricted airways and treat the noisy part of asthma: coughing, wheezing, choking and shortness of breath.

Pharmacy Updates Summary

Oral Agents. Formulary Limits. Available Strengths. IR: 4mg ER: 12mg Syrup: 2mg/5ml

Clinical Policy: Dupilumab (Dupixent) Reference Number: ERX.SPA.49 Effective Date:

Commissioner for the Department for Medicaid Services Selections for Preferred Products

FORMULARY Revised January 2019

Step Therapy Criteria 2019

FORMULARY NOTES ABOUT FORMULARY AND PHARMACY

Oral Agents. Fml Limits. Available Strengths NF NF

Inhaled Corticosteroids Drug Class Prior Authorization Protocol

MEDICAL ASSISTANCE BULLETIN

Inhaled Corticosteroids Drug Class Prior Authorization Protocol

WellCare s South Carolina Preferred Drug List Update

Allergies and Asthma 5/21/2013. Objectives. Allergic Rhinitis (AR): Risk Factor for ASTHMA. Rhinitis and Asthma

UWSP Student Health Service Pharmacy Formulary 1/22/2015

See Important Reminder at the end of this policy for important regulatory and legal information.

FORMULARY Revised January 2018 NOTES ABOUT FORMULARY AND PHARMACY

SmithRx Standard Formulary Step Therapy List

Quarterly pharmacy formulary change notice

Key features and changes to these four components of asthma care include:

Inhaled Corticosteroid Dose Comparison in Asthma

Pharmacy Updates Summary

Drug List exclusions for Blue Cross commercial plans

Quarterly pharmacy formulary change notice

Triage Information: 1. Duration of HPSJ Membership 2. Age 3. Fill history of Seasonal Allergy Medications

Clinical Policy: Omalizumab (Xolair) Reference Number: ERX.SPA.141 Effective Date: Last Review Date: 08.17

ALLERGIC RHINITIS-NASAL

Step Therapy Requirements

Quarterly pharmacy formulary change notice

Amitriptyline Hydrochloride Heart Health & BP Amlodipine Besylate 5mg Norvasc Antibiotics Amoxicillin 500 mg Amoxil

Amitriptyline Hydrochloride Heart Health & BP Amlodipine Besylate 5mg Norvasc Antibiotics Amoxicillin 500 mg Amoxil

Step Therapy Criteria (Criteria for Step Therapy-2 [ST-2] Drugs)

ARBS MEDICATION(S) SUBJECT TO STEP THERAPY DIOVAN HCT MG TAB, DIOVAN HCT MG TABLET

Kentucky Medicaid will incorporate the following changes to its PDL on June 11, 2014:

Behavioral Health. Behavioral Health. Prescribing Guidelines

PHARMA-MEDIC SERVICES INC. POLICY MANUAL

Adapted from: Best Practices for Medication Management for Children & Adolescents in Foster Care. October 2015

Calgary Long Term Care Formulary

Big Lots Behavioral Health. Prescribing Guidelines for Behavioral Health

APPENDIX 1 Printable point-of-care tables Asthma Action Plan Yellow Zone Formulation Table Region: Europe

UPDATE WellCare s South Carolina

Updates to your prescription benefits

JULY 2017 ADDITIONS. NP Thyroid 120mg NP Thyroid 15mg JUNE 2017 CHANGES

Secretary for Health and Family Services Selections for Preferred Products

Berkshire Allergy & Asthma Center 2210 Ridgewood Road, Suite 100 Wyomissing, PA (610)

TRELEGY ELLIPTA (fluticasone-umeclidinium-vilanterol) aerosol powder

Calgary Long Term Care Formulary

Clinical Policy: Omalizumab (Xolair) Reference Number: ERX.SPA.141 Effective Date:

Big Lots Behavioral Health. Prescribing Guidelines for Behavioral Health

Removed from formulary. Removed from formulary. Added to formulary. Quanitity limit changed. Removed from formulary. Removed from formulary

Date: October 3, 2017 To: Participating Providers From: YourCare Health Plan Provider Relations Subject: 2018 Formulary Changes

A Brief Overview of Psychiatric Pharmacotherapy. Joel V. Oberstar, M.D. Chief Executive Officer

UWSP Student Health Service Pharmacy Formulary updated: 1/2017

Data Class: Internal. 1 inhaler (30 blisters OR 14 blisters institutional pack) per presciption

Alprazolam 0.25mg, 0.5mg, 1mg tablets

Step Therapy Requirements. Effective: 12/01/2016

Quarterly pharmacy formulary change notice

Step Therapy Requirements. Effective: 05/01/2018

Effective for all members on August 1, 2017

ADHD Medications Table

University System of Georgia Prior Authorization, Step Therapy and Quantity Limit List (Updated 1/1/2016)

Pain Oral-Intranasal Fentanyl (Abstral, Actiq, Fentora, Lazanda, Onsolis, Subsys)

Upper Peninsula Health Plan Advantage (HMO) (List of Covered Drugs)

Attention: Behavioral Health Providers, Pharmacists and Prescribers N.C. Medicaid and N.C. Health Choice Preferred Drug List Changes - UPDATE

See Important Reminder at the end of this policy for important regulatory and legal information.

MEDICAL ASSISTANCE BULLETIN

Aetna Better Health of Michigan 1333 Gratiot Avenue, Suite 400 Detroit, MI AETNA BETTER HEALTH January 2017 Formulary Change(s)

CRITERIA Trial of two generic formulary products from the following: atomoxetine or ADHD stimulant medication.

Amerigroup Washington, Inc. to conduct postservice reviews of certain modifiers and services

Parents Guide to ADHD Medications. Copyright Child Mind Institute

Medication Policy Manual. Topic: Dupixent, dupilumab Date of Origin: March 10, Committee Approval: March 10, 2017 Next Review Date: May 2018

THERAPEUTIC AREA NAME STRENGTH DOSAGE FORM

Clinical Policy: Dupilumab (Dupixent) Reference Number: ERX.SPA.49 Effective Date:

A Visual Approach to Simplifying Respiratory Drug Regimens

2015 Step Therapy Prior Authorization Medical Necessity Guidelines

THERAPEUTIC AREA NAME STRENGTH DOSAGE FORM

Transcription:

Follow the links below to access the complete formularies for Plans: Buckeye Health Plan Acne Allergy Allergic Anaphylactic Reaction Allergic Conjunctivitis Allergic Rhinitis Asthma Atopic Dermatitis Behavioral Health TABLE OF CONTENTS (Click on a link below to view the section.) Anxiety Disorders & Depression Attention Deficit Hyperactivity Disorder Diabetes Gastroesophageal Reflux Head Lice Oral Antibiotics Otic Antibiotics

Benzoyl Peroxide (BPO ) Clindamycin Phosphate (Cleocin-T ) Erythromycin Adapalene (Differin ) Tretinoin (Retin-A ) Benzoyl Peroxide/ Erythromycin (Benzamycin ) Clindamycin/ Benzoyl Peroxide ACNE Topical Anti-bacterials 2.5%, 5%, 10% Gel or Liquid $21 1% Gel, 1% Lotion $110 1% Solution $49 2% Gel $171 PA 2% Solution $50 0.3% Gel, 0.1% Cream, 0.1% Lotion (Rx) $171 PA cream & gel PA PA PA 0.1% Gel (OTC) $106 PA PA 0.025%, 0.05% 0.1% Cream; 0.01%, 0.025% Gel Topical Retinoids Topical Combinations $188 PA PA 5-3% Gel $227 PA PA PA 1-5% Gel (Benzaclin ) $240 PA PA PA PA 1.2-5% Gel (Duac ) $123 PA PA PA PA

Doxycycline monohydrate Minocycline Isotretinoin (Claravis, Myorisan, Zenatane ) ACNE (CONTINUED) Oral Antibiotics 50 mg, 100 mg (capsule preferred) 50 mg, 75 mg, 100 mg (capsule preferred) Oral Retinoids $33 PA PA PA PA $37 10mg-40mg $648 PA PA PA PA PA PA

Adrenaclick 0.3mg/0.3mL, 0.15mg/0.15mL $170 PA PA PA Auvi-Q 0.3mg/0.3mL, 0.15mg/0.15mL $5,400 PA PA PA PA PA PA EpiPen 0.3mg/0.3mL, 0.15mg/0.15mL $156 EpiPen Jr. 0.15mg/0.3ml Azelastine 0.05% $31 PA PA Cromolyn 4% $19 Ketotifen (Alaway, Zatidor ) ALLERGIC ANAPHYLACTIC REACTION Epinephrine Auto-injector ALLERGIC CONJUNCTIVITIS Ophthalmic Antihistamines 0.025% $22 PA

Cetirizine (Zyrtec ) Fexofenadine (Allegra ) Loratadine (Claritin ) 5, 10 mg $48 1 mg/ml $18 < 6 yo 30 mg/5 ml $30 PA PA PA 60 mg, 180 mg $30 PA PA 180 mg 10 mg $20 1 mg/ml $27 5 mg Chew $26 PA Azelastine 0.15%, 0.1% $49 PA Budesonide (Rhinocort Allergy) 32 mcg/act $28 PA PA PA PA Flunisolide 25 mcg/act $65 PA Fluticasone (Flonase ) Triamcinolone (Nasacort ) ALLERGIC RHINITIS Oral Antihistamines Nasal Antihistamines Nasal Steroids 50 mcg/act $27 55 mcg/act $27 PA PA PA

Albuterol Solution 2.5 mg/3 ml $28 Albuterol (Preferred: Ventolin HFA) Beclomethasone dipropionate (Qvar HFA) Budesonide (Pulmicort Flexhaler ) Budesonide (Pulmicort Respules ) Flunisolide (Aerospan HFA) No dose counter Fluticasone furoate (Arnuity Ellipta ) Fluticasone propionate (Flovent Diskus ) Fluticasone propionate (Flovent HFA) ASTHMA Beta-2 Adrenergic Agonists 90 mcg/act $63 Inhaled Corticosteroids 40 mcg/act, 80 mcg/act $220 PA PA PA PA 90 mcg, 180 mcg DPI $227 PA PA PA PA 0.25 mg/2 ml, 0.5 mg/2ml, 1 mg/2ml $241 1-8 yo < 4 yo 80 mcg/act $245 PA PA PA PA 100 mcg DPI, 200 mcg DPI 50 mcg DPI, 100 mcg DPI, 250 mcg DPI 44 mcg/act, 110 mcg/act, 220 mcg/act $223 PA PA PA PA $206 PA PA PA $275 PA PA PA

Mometasone furoate (Asmanex HFA) Mometasone furoate (Asmanex Twisthaler ) Budesonide/formoterol (Symbicort ) Fluticasone/salmeterol (Advair Diskus ) Fluticasone/salmeterol (Advair HFA ) Fluticasone/salmeterol (AirDuo RespiClick ) Mometasone/formoterol (Dulera HFA) Montelukast (Singulair ) ASTHMA (CONTINUED) Inhaled Corticosteroids (Continued) 100 mcg/act, 200 mcg/act $250 PA PA PA 110 mcg, 220 mcg DPI $270 PA PA PA Inhaled Beta-2 Adrenergic Agonist/Corticosteroid 80-4.5 mcg/act, 160-4.5 mcg/act 100-50 mcg, 250-50 mcg, 500-50 mcg DPI 115-21 mcg/act, 230-21 mcg/act, 45-21mcg/act 55-14 mcg, 113-14 mcg, 232-14 mcg 100-5 mcg/act,200-5 mcg/act 4 mg (Oral packet), 4, 5 mg (Chew), 10 mg (Tablet) $235 PA PA PA $434 PA PA PA PA 100-50 $272 PA PA PA PA PA $113 PA PA PA PA $236 Leukotriene Receptor Antagonists < 12 yo $41

Escitalopram (Lexapro ) Fluoxetine (Prozac ) Sertraline (Zoloft ) Duloxetine (Cymbalta ) Dexmethylphenidate Immediate Release (Focalin ) Dexmethylphenidate Long-Acting (Focalin XR ) Dextroamphetamine- Amphetamine Immediate Release (Adderall ) Dextroamphetamine- Amphetamine Long- Acting (Adderall XR ) ANXIETY DISORDERS/DEPRESSION Selective Serotonin Reuptake Inhibitors 5, 10, 20 mg $17 10, 20, 40, 60 mg (capsules preferred) $16 25, 50, 100 mg $16 Serotonin-Norepinephrine Reuptake Inhibitors 20, 30, 60 mg (capsules preferred) $22 PA ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD) Stimulants 2.5, 5, 10 mg $53 5, 10, 15, 20, 25, 30, 35, 40 mg 5, 7.5, 10, 12.5, 15, 20, 30 mg $155 PA PA $47 5, 10, 15, 20, 25, 30 mg $86 PA

ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD) (CONTINUED) Stimulants (Continued) Lisdexamfetamine (Vyvanse ) Methylphenidate Immediate Release (Ritalin ) Methylphenidate Long-Acting (Concerta ) Methylphenidate Long- Acting (Metadate CD ) Methylphenidate Long-Acting (Ritalin LA ) Atomoxetine (Strattera ) Clonidine (Catapres ) Clonidine Extended Release (Kapvay ) Guanfacine (Tenex ) Guanfacine ER (Intuniv ) 10, 20, 30, 40, 50, 60, 70 mg $325 PA PA PA 5, 10, 20 mg $45 18, 27, 36, 54 mg $246 PA 10, 20, 30, 40, 50, 60 mg $132 PA PA 10, 60 mg $342 PA PA PA PA 20, 30, 40 mg $129 PA PA 10, 18, 25, 40, 60, 80, 100 mg Non-Stimulants $216 PA 0.1 mg, 0.2 mg, 0.3 mg $18 0.1 mg $180 PA PA PA PA PA 1, 2 mg $17 1, 2, 3, 4 mg $32 PA

Hydrocortisone External Alclometasone (Aclovate ) Betamethasone valerate (Diprolene External) Fluocinolone acetate (Synalar ) Triamcinolone acetonide (Kenalog ) Betamethasone valerate (Diprolene External) Fluocinolone acetate (Synalar ) Fluticasone propionate (Cutivate External) Mometasone furoate (Elocon External) Triamcinolone acetonide (Kenalog ) ATOPIC DERMATITIS Class 7 Topical Corticosteroids-Least Potent 0.5%, 0.1%, 2.5% Cream and Ointment; 1% Lotion $19 Class 6 Topical Corticosteroids-Mild Potency 0.05% Cream, Ointment $92 PA PA 0.1% Lotion $57 0.01% Cream $127 PA PA PA PA PA 0.025% Cream; 0.025% Lotion $32 Class 5 Topical Corticosteroids-Lower Mid Potency 0.1% Cream, Ointment $51 0.025% Cream, Ointment 0.005% Ointment; 0.05% Cream $104 PA $40 0.1% Cream, Lotion $28 0.025% Ointment $25 Classes 1-4 topical corticosteroids are not listed since most patients are treated with classes 5-7 topical corticosteroids.

Insulin degludec (Tresiba ) Insulin detemir (Levemir ) Insulin glargine (Basaglar ) Insulin glargine (Lantus ) Insulin aspart protamine/insulin aspart (Novolog 70-30 ) Insulin NPH/insulin regular (Humulin 70/30 ) Insulin NPH/insulin regular (Novolin 70/30 ) Diabetes Long Acting Insulin 100, 200 units/ml Flextouch pen (3mL/pen) $639 PA PA PA PA PA 100 units/ml vial $323 PA PA PA PA PA 100 units/ml Flextouch pen (3mL/pen) 100 units/ml Kwikpen (3mL/pen) $484 PA PA PA PA PA $380 PA 100 units/ml vial $307 PA PA PA PA PA 100 units/ml Solostar pen (3mL/pen) $461 PA PA PA PA PA 100 units/ml vial $343 100 units/ml Flexpen (3mL/pen) $639 PA PA 100 units/ml vial $178 PA 100 units/ml Kwikpen (3mL/pen) Mixed Insulin $566 PA PA PA 100 units/ml vial $165 PA

Insulin NPH (Humulin N) Insulin NPH (Novolin N) Insulin aspart (Novolog ) Insulin glulisine (Apidra ) Insulin lispro (Humalog ) Insulin regular (Humulin R ) Insulin regular (Novolin R ) Diabetes Intermediate Acting Insulin 100 units/ml vial $178 PA 100 units/ml Kwikpen (3mL/pen) $566 PA PA PA 100 units/ml vial $165 PA Short Acting Insulin 100 units/ml vials $331 100 units/ml Flexpen (3mL/pen) $639 PA 100 units/ml vial $306 PA PA PA 100 units/ml Solostar pen (3mL/pen) $591 PA PA PA 100 units/ml vial $330 100 units/ml Kwikpen (3mL/pen) $636 PA 100 units/ml vial $178 PA 100 units/ml vial $165 PA

Famotidine (Pepcid ) Ranitidine (Zantac ) Esomeprazole (Nexium ) Lansoprazole (Prevacid ) Omeprazole (Prilosec ) GASTROESOPHAGEAL REFLUX H2 Antihistamines 10, 20, 40 mg $19 40 mg/5ml $58 75, 150, 300 mg $35 150 mg 15 mg/ml $28 Proton Pump Inhibitors 20 mg, 40 mg $33 20 mg OTC (Nexium 24HR) PA PA PA PA PA 20 mg $20 PA PA 15 mg, 30 mg Capsules $25 PA PA 15 mg OTC (Prevacid 24HR) $22 PA PA PA 15, 30 mg Solutabs $498 PA PA PA PA PA 3 mg/ml First Lansoprazole $83 PA PA PA PA PA 10, 20, 40 mg Capsules $18 PA 2 mg/ml First Omeprazole $72 PA PA PA PA

Benzyl alcohol (Ulesfia ) Ivermectin lotion (Sklice ) Malathion lotion (Ovide ) Permethrin (Nix ) Pyrethrins/piperonyl butoxide (LiceMD /RID ) Spinosad suspension (Natroba ) HEAD LICE Topical Pediculocides 5% $237 PA PA PA PA PA PA 0.5% $412 PA PA PA PA 0.5% $225 PA PA 1% $10 0.33%-4% $7 PA PA 0.9% $266 PA

ORAL ANTIBIOTICS (CONTINUED) Fluoroquinolones Ciprofloxacin (Cipro ) Levofloxacin (Levaquin ) Azithromycin (Zithromax ) Clarithromycin (Biaxin ) Erythromycin (E.E.S., Ery-Tab ) Erythromycin Ethylsuccinate (EryPed ) Sulfamethoxazole/ Trimethoprim (Bactrim ) 250 mg, 500 mg 250 mg/5 ml, 500 mg/5ml $174 PA 250 mg, 500 mg $20 25mg/mL $105 PA PA 250 mg, 500 mg $20 100 mg/5ml, 200 mg/5 ml 125 mg/5 ml, 250 mg/5ml $36 $119 250 mg, 500 mg $35 250 mg, 333 mg, 400 mg, 500 mg $303 PA 400 mg/5 ml $794 PA 400 mg-80 mg, 800 mg-160 mg $18 Macrolides Sulfonamides $17 200 mg-40 mg/5 ml $30

Clindamycin (Cleocin ) Metronidazole (Flagyl ) Nitrofurantoin monohydrate Nitrofurantoin (Furadantin ) ORAL ANTIBIOTICS (CONTINUED) Miscellaneous 75 mg, 150 mg $17 150 mg 150 mg 75 mg/5 ml $41 250, 500 mg $22 100 mg $27 25 mg/5 ml $289

Ofloxacin Ciprofloxacin/ dexamethasone (Ciprodex ) Ciprofloxacin (Cetraxal ) OTIC ANTIBIOTICS Otic Anti-infectives 0.3% Floxin Otic $175 0.3% Ocuflox Opthl. $135 0.3/0.1% suspension $241 PA PA PA 0.2% solution $102 PA PA PA PA