Prior Authorization Drug List
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1 Prior Authorization Drug List This is a list of drugs that require Prior Authorization before coverage is provided. If you are prescribed a medication that requires Prior Authorization, your physician will need to contact ClearScript at the number provided on your ID card to request a prior authorization review. ClearScript will review the request to determine if the medication use is consistent with your benefit coverage and will notify you and your physician of the coverage determination. Without prior authorization approval, these drugs may not be covered by your pharmacy benefit. This list is subject to change throughout the year. The presence of a drug on this list does not guarantee coverage and not all drugs included on this list may be covered by your pharmacy benefit plan. Coverage of medications is determined your benefit plan. Your plan may require prior authorization for additional medications not included on this list. Drug Class ANALGESICS diclofenac sodium fentanyl citrate OPANA ER ANTIBACTERIALS BAXDELA SOLOSEC XIFAXAN ANTICONVULSANTS ONFI SABRIL vigabatrin ANTIDEPRESSANTS EMSAM ANTIEMETICS CESAMET dronabinol CRESEMBA SPORANOX ANTIFUNGALS voriconazole ANTINEOPLASTICS AFINITOR AFINITOR DISPERZ ALECENSA ALUNBRIG
2 ANTINEOPLASTICS -- Continued bexarotene BOSULIF CABOMETYX CALQUENCE capecitabine CAPRELSA COMETRIQ COTELLIC ERIVEDGE ERLEADA FARYDAK GILOTRIF HYCAMTIN IBRANCE ICLUSIG IDHIFA imatinib mesylate IMBRUVICA INLYTA IRESSA JAKAFI KISQALI LENVIMA LONSURF LYNPARZA MEKINIST NERLYNX NEXAVAR NINLARO ODOMZO POMALYST REVLIMID RUBRACA RYDAPT SPRYCEL STIVARGA SUTENT SYNRIBO TAFINLAR TAGRISSO TARCEVA TARGRETIN TASIGNA temozolomide THALOMID TYKERB VALCHLOR VENCLEXTA VENCLEXTA STARTING PACK VERZENIO VOTRIENT XALKORI XTANDI ZEJULA ZELBORAF ZOLINZA ZYDELIG ZYKADIA
3 ZYTIGA ANTIPARASITICS Drug Class ANTIPARASITICS -- Continued DARAPRIM ANTIPARKINSON AGENTS APOKYN DUOPA ANTIPSYCHOTICS ANTIVIRALS NUPLAZID DAKLINZA HARVONI MAVYRET PEGASYS PEGINTRON PREVYMIS TECHNIVIE VIEKIRA XR ZEPATIER EPCLUSA INTRON A OLYSIO PEGASYS PROCLICK PEGINTRON REDIPEN SOVALDI VIEKIRA PAK VOSEVI BLOOD GLUCOSE REGULATORS AFREZZA SYMLINPEN 120 SYMLINPEN 60 BLOOD PRODUCTS/MODIFIERS/VOLUME EXPANDERS ARANESP GRANIX MIRCERA PROCRIT ZARXIO CARDIOVASCULAR AGENTS CORLANOR JUXTAPID KYNAMRO PRALUENT PEN EPOGEN HEMLIBRA NEUPOGEN PROMACTA ENTRESTO KEVEYIS NORTHERA PRALUENT SYRINGE
4 CARDIOVASCULAR AGENTS -- Continued REPATHA PUSHTRONEX REPATHA SURECLICK REPATHA SYRINGE CENTRAL NERVOUS SYSTEM AGENTS AMPYRA AUSTEDO AVONEX PEN COPAXONE GILENYA INGREZZA PLEGRIDY REBIF RILUTEK TECFIDERA XENAZINE DERMATOLOGICAL AGENTS adapalene COSENTYX PEN COSENTYX SYRINGE REGRANEX TALTZ AUTOINJECTOR TALTZ AUTOINJECTOR (3 PACK) TALTZ SYRINGE (2 PACK) TREMFYA ENZYME REPLACEMENT/MODIFIERS CERDELGA miglustat RAVICTI ZAVESCA GASTROINTESTINAL AGENTS alosetron hcl GATTEX AUBAGIO AVONEX BETASERON EXTAVIA glatiramer acetate NUEDEXTA PLEGRIDY PEN REBIF REBIDOSE riluzole tetrabenazine ZINBRYTA COSENTYX (2 SYRINGES) COSENTYX PEN (2 PENS) DUPIXENT STELARA TALTZ AUTOINJECTOR (2 PACK) TALTZ SYRINGE TALTZ SYRINGE (3 PACK) KUVAN ORFADIN STRENSIQ CHOLBAM OCALIVA
5 GASTROINTESTINAL AGENTS -- Continued RELISTOR XERMELO VIBERZI GENITOURINARY AGENTS CUPRIMINE HORMONAL AGENTS, STIMULANT/REPLACEMENT/MODIFYING (ADRENAL) EMFLAZA HORMONAL AGENTS, STIMULANT/REPLACEMENT/MODIFYING (PITUITARY) chorionic gonadotropin, human GENOTROPIN H.P. ACTHAR HUMATROPE INCRELEX NORDITROPIN FLEXPRO NUTROPIN AQ NUTROPIN AQ NUSPIN OMNITROPE SAIZEN SAIZEN-SAIZENPREP SEROSTIM ZOMACTON ZORBTIVE HORMONAL AGENTS, STIMULANT/REPLACEMENT/MODIFYING (SEX HORMONES/MODIFIERS) ANADROL-50 ANDROGEL ANDROID fluoxymesterone methyltestosterone oxandrolone testosterone TESTRED HORMONAL AGENTS, SUPPRESSANT (PARATHYROID) SENSIPAR HORMONAL AGENTS, SUPPRESSANT (PITUITARY) leuprolide acetate SANDOSTATIN SIGNIFOR SOMATULINE DEPOT IMMUNOLOGICAL AGENTS ACTEMRA CIMZIA ENBREL MINI FIRAZYR octreotide acetate SANDOSTATIN LAR DEPOT SIGNIFOR LAR SOMAVERT BENLYSTA ENBREL ENBREL SURECLICK HAEGARDA
6 IMMUNOLOGICAL AGENTS -- Continued HUMIRA HUMIRA PEN HUMIRA PEN PSORIASIS-UVEITIS KINERET ORENCIA CLICKJECT SILIQ XELJANZ ZORTRESS HUMIRA PEDIATRIC CROHN'S HUMIRA PEN CROHN-UC-HS STARTER KEVZARA ORENCIA OTEZLA SIMPONI XELJANZ XR METABOLIC BONE DISEASE AGENTS FORTEO TYMLOS MISCELLANEOUS THERAPEUTIC AGENTS ADDYI clomiphene citrate ODACTRA NATPARA CETROTIDE MYALEPT XURIDEN OPHTHALMIC AGENTS CYSTARAN RESPIRATORY TRACT/PULMONARY AGENTS ADCIRCA CAYSTON ESBRIET KALYDECO OFEV ORALAIR ORKAMBI RAGWITEK sildenafil citrate tadalafil TYVASO TYVASO REFILL KIT UPTRAVI ADEMPAS DALIRESP GRASTEK LETAIRIS OPSUMIT ORENITRAM ER PULMOZYME REMODULIN SYMDEKO TRACLEER TYVASO INSTITUTIONAL START KIT TYVASO STARTER KIT VENTAVIS
7 SLEEP DISORDER AGENTS HETLIOZ THERAPEUTIC NUTRIENTS/MINERALS/ELECTROLYTES ENDARI FERRIPROX JADENU SPRINKLE EXJADE JADENU SYPRINE
Please scroll down for list of drugs
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Please scroll down for list of drugs
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Ambrisentan (Letairis) LETAIRIS Pregnancy 1 apomorphine (Apokyn) APOKYN 2 Apremilast (Otezla) OTEZLA, OTEZLA STARTER ORAL TABLETS,DOSE PACK 10 MG (4)-20 MG (4)-30 MG (47) 3 Aprepitant (Emend) aprepitant
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