Specialty drug list 2022. Select FDA-approved specialty medications .

Specialty drug list 2022 This document contains Get expert advice from specialty-trained pharmacists and nurses available 24/7. Medication Brand Name HCPCS Code (Medical Drugs only) Medical Oncology Program High- Cost Review Medical x February 2022: Abrilada x x: July 2023 Actemra J3262: x x: x x: April 2021 Actemra ACTPEN x: x January 2020: Acthar x x: January 2016 Acthar Gel J0801 ENTER A PROCEDURE CODE OR DRUG NAME. June 2020. Title: Microsoft Word - Document3 Author: dp27367 Created Date: 7/13/2022 11:57:02 AM CVS Caremark® Managed Prescription Drug Formulary The drug list, administered by CVS Caremark on behalf of HealthTrust, is a guide within select therapeutic categories for clients, plan members and health care providers. Complete Drug List (Formulary) 2025 Important notes: This document has information about the drugs covered by this plan. 2024 Aetna Specialty Drug List 1011950-01-10 (7/24) How to use this guide You may fill these drugs at an in-network specialty pharmacy. 6 %âãÏÓ 13071 0 obj > endobj 13089 0 obj >/Filter/FlateDecode/ID[4A3F19AF60CBE84AA7934B6AE3DD9041>62D291D35FFCCB48850A7FE787A8762E>]/Index[13071 27]/Info 2022 . For 2022, we expect overall prescription drug spending to rise by 4. com, fax 1-800-323-2445 or call 1-866-845-6786 for more information about medications available through CVS Specialty®. Call CVS Specialty at 1-800-237-2767 for specific medications available through CVS Specialty. Specialty Drug List effective April 1, 2022. Download our brand contraceptive copay waiver form . The specialty drug pipeline has expanded accordingly, with an expected Blue Cross and Blue Shield of Illinois (BCBSIL) is pleased to present the 2022 Drug List. Reference product . Medications are listed alphabetically by condition with generic medications listed in all lowercase letters and brand-name medications in all capital letters. Please note, this information is specific to the MMC and CHPlus programs only. Prospective Patients: Ready to get started? Enroll to get your medications from CVS Specialty. These types of drugs are labeled in the formulary as “NDS” under the Requirements/Limits NYWPEC-2232-21 January 2022 Specialty Drug List Highmark Blue Cross Blue Shield of Western New York partners with Amerigroup companies to administer certain services to Medicaid Managed Care (MMC) and Child Health Plus (CHPlus) members. Premium . Several new drugs that are likely to influence spending are expected to be approved in 2022. Specialty and cancer drugs will continue to drive expenditures along with the evolution of the COVID-19 pandemic. The SDL includes drugs that managed care organizations (MCOs) may exclusively provide through their specialty pharmacy network. You may fill these drugs at an in-network specialty pharmacy. Refer to the Specialty Drugs Handbook for more information about the SDL. us. December 2022; November 2022; October 2022; September 2022; August 2022; July 2022; June 2022; May 2022; April 2022; March 2022; February 2022; January 2022 For the most current list of covered medications or if you have questions: Call the number on your member ID card. The March 2022 biannual SDL is now available. Pharmacy Benefit Prior Authorizations This list only applies to the medications requiring PA through the Medical Benefit. Brand name drugs not listed in this Prescription Drug Guide are Non -Preferred Brands. 8 . Pegasys Pegintron Rebetol Ribapak ribasphere ribavirin Sofosbuvir/Velpatasvir Sovaldi Technivie Vemlidy Viekira/XR Vosevi Zepatier Hereditary Angioedema Berinert Cinryze Firazyr Haegarda Icatibant Kalbitor Ruconest Sajazir Takhzyro Immunodeficiency Asceniv Bivigam Carimune NF Cutaquig Specialty pharmacy drug list Optum® Specialty Pharmacy provides specialty medication support through your pharmacy benefits with Optum Rx. NF : Non-formulary ; This product is not covered unless you or your provider request an exception. PDL October 1 2022 Revised 1. * You will pay a maximum of $35 for each 1-month supply of Part D covered insulin drugs through all drug payment stages, except the Catastrophic drug payment stage, where you pay $0. Effective July 1, 2022. The . Specialty medications are used to treat complex conditions and are generally higher in cost. Although some are oral medications, the majority of specialty drugs are injected and may require special handling (e. Plan of the Mid-Atlantic States, Inc. Optum Specialty Pharmacy provides comprehensive support services, July 1, 2022. ©2022 CVS Health and/or its affiliates. Formulary ID Number: 22039, v7 This formulary was updated on 08/24/2021. This list is intended for use with UnitedHealthcare health plans and affiliated companies’ pharmacy benefit plan designs. This drug list is updated often so it isn’t a complete list of Specialty medications can be covered under the pharmacy benefit, the medical benefit or both benefits, depending on the benefit structure applied to the coverage policy. ; Select Health Medicare is our drug list for members with Select Health Medicare coverage. Specialty Pharmacy Drug List is a guide of medications available and distributed through CVS Specialty®. Drug name / Manufacturer . The CVS Specialty Pharmacy Distribution Drug List is a guide of medications available and distributed through CVS Specialty. Generics should be considered the first line of prescribing. Your plan may not cover certain medications even though they appear on the ES with HIV and without Fertility Specialty Drug List November 2022 Medications listed below are covered under the PrudentRx Program Brand-name drugs are capitalized (e. If you are a plan member or a health care provider, please visit CVSspecialty. Contents Call CVS Specialty at 1-800-237-2767 for specific medications available through CVS Specialty. 2101 East Jefferson Street, Rockville, MD 20852 . e-Prescribe specialty prescription(s) to CVS Specialty Pharmacy. Brand-name medications are capitalized and generic medications are lowercase. Email comments or questions to vdp-formulary@hhsc. 2022 Essential Health Benefits . Our Use these search tools to find medications that Optum Specialty Pharmacy and/or Optum Infusion Pharmacy can provide or facilitate access to. Enhanced Exclusive Specialty with HIV and without Fertility Specialty Drug List November 2022 44150MUMENCRX Rev. Our network of pharmacies includes certifications and accreditations from the Joint This is a list of the specialty medications that have be filled through Accredo as of July 1, 20211,2 Medications are listed alphabetically. Listing is subject to change. A drug may not be added to the Preferred Brand tier for reasons including safety or effectiveness, or because a similar, more cost -effective drug is already %PDF-1. 0% to 6. Subscribe for updates (SGM) Drug List SGM is a comprehensive utilization management program that helps promote patient safety and ensure appropriate utilization of specialty medications. What Are Specialty Drugs? They’re prescription medications that are used to treat complex or chronic medical Specialty drugs are used to treat chronic or serious conditions such as rheumatoid arthritis, cancer, or multiple sclerosis. 0%, whereas in clinics and hospitals we anticipate [Drugs & Biologics] A-Z Index: View Documents > Medication Administration Site of Care - [1605]). You can view the most up-to-date list, or the specialty drug list , at MyPrime. 150213_SpecialtyDrugList_M _ 2/1/2022–12/31/2022 . Current Specialty Medication List (as of 2/1/2025) New Drug Additions in Bold text. Learn about ACA contraceptive drug list . A abiraterone acetate (ZYTIGA*) 2025 Prescription Drug List Introduction The UnitedHealthcare Prescription Drug List (PDL)1 provides a list of the most commonly prescribed medications in various therapeutic classes. Medications are listed alphabetically by the condition they treat. SPECIALTY MEDICATIONS A new, rapidly growing category of drugs, specialty medications are the result of continued advances in drug The Comprehensive Specialty Pharmacy Drug List is a guide of medications available and distributed through CVS Specialty®. CVS Specialty ® dispenses a wide array of specialty medication used to treat many health conditions. We do not warrant that the Drugs listed under Tier 3 generally have higher copayments than preferred brand-name drugs and may include some specialty or high-cost drugs*. %PDF-1. 6 We evaluate all specialty generic drugs dispensed during our 2017-2022 study period. For all other plans, continue to fill these medications through approved pharmacy. ABILIFY MYCI TAB 2MG STRT . In order to receive a National Drug File Support Group Guidelines : National Formulary Frequently Asked Questions : Non-Promotable List: VA No Buy List: VA Drug Standardization List: List of Medications at Lower Copayment Rate Under 38 CFR 17. Formulary Introduction In the event that your appeal is successful, non-specialty non-formulary drugs will be covered at your Tier 3 cost-share (co-pay or co-insurance) and specialty non-formulary drugs will be covered at your Tier 4 cost-share (co-pay or Drug Lists / Formularies. October 2022 Please consider talking to your doctor about prescribing preferred medications, which may help reduce your The drug list is regularly updated. Examples include multiple sclerosis, hepatitis C, HIV and cancer. This list is updated quarterly. For more recent information or to price a medication, you 2022 SaveOnSP Drug List Effective January 1, 2022 The SaveOnSP Drug List is subject to change at any time. 7 %µµµµ 1 0 obj >/Metadata 1675 0 R/ViewerPreferences 1676 0 R>> endobj 2 0 obj > endobj 3 0 obj >/ExtGState >/Font >/ProcSet[/PDF/Text/ImageB/ImageC Specialty drugs are having a moment: Between 2015 and 2021, specialty pharmacies grew by 315%, according to data presented at Asembia’s 2022 Specialty Pharmacy Summit, 1 with hospital or health system–owned specialty pharmacies accounting for one-third of the total growth. tx. Medications on the PrudentRx specialty drug list may change at any time, with or without notice. Additionally, this list contains drugs that may be on a 180 Day Hold and/or the Drug Removal Table list. Prescription drug coverage varies by member benefit plan. Find out if your medication is available through CVS Specialty. For more Specialty Tier. Pharmacy benefit medications are typically self-administered by the patient or a caregiver, after filling the prescription through a specialty pharmacy. All available covered drugs are shown on this list . Alternative medications are listed next to non-covered product : RX/OTC ; Prescription and OTC : These drugs are made in both 2025 Aetna Specialty Drug List. With more than 40 years of experience, CVS Specialty provides quality care and service. You’ll also learn more about the requirements and limitations of your pharmacy benefits and insurance plan. You’ll also learn more about the requirements and limitations of your pharmacy The drug list includes all covered prescription drugs, including generic, brand name and specialty drugs for your plan. pdf. PRESS "CTRL" AND "F" KEYS AT THE SAME TIME TO BRING UP THE SEARCH BOX. SuperiorHealthPlan. Also, your plan may not (SGM) Drug List SGM is a comprehensive utilization management program that helps promote patient safety and ensure appropriate utilization of specialty medications. 110(b)(iv) VA Product Name List - Excel Spreadsheet (updated February 2025) VA National Drug File Extract with NDC - Excel The Prescription Drug List (PDL) is a list of prescription medications commonly chosen by doctors and pharmacies. These drugs may be injected, infused or taken by mouth. List of Drugs Change Notice. This drug list is automatically updated so it provides the latest list of medications. Drugs may be added or removed from our list of drugs during the year. Depending on the condition These nationally recognized symbols reflect an organization’s commitment to meet highest standards of quality, compliance and safety. You can fill your prescriptions at over 55,000 retail pharmacies, through the FEP Mail Service Program or the FEP Your 2022 Prescription Drug List Advantage 4-Tier This Prescription Drug List (PDL) is accurate as of January 1, 2022 and is subject to change after this date. Click if PDF not visible For medical benefit specialty medication prior authorizations, please use the forms posted on the OhioHealthy website OR click associated link Archimedes Specialty Drug Authorization Form and fax to 866-491-6971. drugs. Your plan may not cover certain medications even though they appear on the PrudentRx drug list. Visit your plan’s website on your member ID card or log on to the Optum Rx app to: • Find a participating retail pharmacy by ZIP code. 2022 Commercial Specialty Pharmacy Prior Authorization Drug List Posted May 2022 to reference changes that will be effective August 2022 General Information: The list below includes Specialty Pharmacy (infusion site-of-care or provider administered drug therapies, including cellular immunotherapy, gene The Prescription Drug Guide includes all Preferred Brand drugs and a partial listing of Generic drugs. For the most current list of covered medications or if you have questions: Call the number on your member ID card. Reliance on any information provided by the National Drug Codes List website or other visitors to this website is solely at your own risk. Suggest a change or addition to our drug lists. Prescription written for . Frequently asked questions Which specialty medical drugs does site of care apply to? The list of specialty drugs eligible for redirection is provided after this section. ENTER A PROCEDURE CODE OR DRUG NAME. com or bcbstx. This document contains Medica Drug List PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN YOUR PLAN. Remove a drug from the list; Change drug requirements; Move a drug to a Abu Dhabi Approved Drug List* - 16467 total approved coded drug products - 4426 non registered coded drug product with Special authorization approval - Dec 2022. specialty medication that is on a higher tier, call the toll-free phone number on your health plan ID card to talk with a pharmacist about finding lower-cost options. 1,2 Medications are listed alphabetically. Schedule delivery of your specialty drugs to your home or office on a day that works for you at no additional cost. ABILIFY MYCI TAB 2MG MANT . 1-800-323-2445; e-Prescribe: CVS Specialty Pharmacy. ; RxCore is a more cost-effective drug list with five tiers of coverage. These specialty medications may:Treat chronic and life-threatening diseasesHave a high costInclude complex administrationCause adverse reactionsRequire temperature control or other specialized handlingBe restricted as 2022 specialty drug list acromegaly electrolyte disorders hemophilia octreotide acetate 1 keveyis ldd 3 koate ldd 3 sandostatin 3 samsca ldd 3 koate-dvi ldd 3 somatuline depot ldd 2 tolvaptan 1 kogenate fs ldd 2 alpha-1 antitrypsin deficiency enzyme deficiency disorders - other kovaltry ldd 2 This list is not an all-inclusive specialty drug list. Conclusion. for membersof commercial healthplans and Medicare Part D prescriptiondrug plans managed by the Big 3 PBMs for which we have relevant data—which includes 51 drugs 2022Prescription Drug List Effective January 1, 2022 Ambetter. g. Your plan may not cover certain medications even though they appear on the PrudentRx EES with Fertility and with HIV Specialty Drug List March 2022 Medications listed below are covered under the PrudentRx Program Brand-name drugs are capitalized NC Medicaid's preferred drug list or PDL. 27. Manage your specialty medications and set refill reminders. Question: What are some of the more significant Specialty Pharmacy Drug List Providing one of the broadest offerings of specialty pharmaceuticals in the industry The Specialty Pharmacy Drug List is a guide of medications available through CVS Specialty®. Approved New Coding Structure. 1011950-01-12 (1/25)-How to use this guide . This document contains confidential and proprietary information of CVS Specialty and may not be reproduced, distributed or printed without written permission from CVS Specialty. Standard Formulary. Open configuration options. FDA-Approved Indication(s) Administration Route / Concentration . Keep up to date on the latest drug recalls and alerts. While specialty drugs are very effective in decreasing the debilitating effects of certain diseases, their costs are significantly higher than traditional drugs and some are effective Humira and Biosimilars for Humira Drug List . Specialty Drugs Oralair Repatha Susvimo Tyvaso Yutiq Orencia IV Retacrit Sutent Ubrelvy Zaltrap Orencia SC Retevmo Sylvant Uceris Zarxio Orenitram Retisert Symdeko Udenyca Zavesca Orfadin Retrovir Symfi Ultomiris Zejula Orgovyx Retrovir IV Symtuza Unituxin Zelboraf 4-Tier Specialty Prescription Drug List as of January 1, 2025. The contents of the National Drug Codes List website are provided for educational purposes only and are not intended in any way as medical advice, medical diagnosis, or treatment. The inclusion of a particular specialty prescription drugs within the SaveOnSP Program is subject to SaveOnSP Program design, as well as applicable laws or regulations. If the medication you are searching for is taken orally or by injection, or to be administered via infusion at a prescriber’s office or clinic, please contact our Optum Specialty 2022 CIGNA COMPREHENSIVE DRUG LIST (Formulary) HPMS Approved Formulary File Submission ID 22233, Version Number 16 This formulary was updated on 12/01/2022. April 2022 *Indicates intravenous (IV) route of administration (all or some forms). Non registered Source by country. 24. PA Prior authorization reuired ST Step therapy 2 Specialty pharmacy drug list Genentic Disorder Oxlumo PA Ryplazim PA When a generic drug is substituted for a brand-name drug, you can expect the generic to produce the same clinical effect and safety profile as the brand-name drug (therapeutic equivalence). Read more about how we evaluate care options. Commercial Prescription Drug List - Effective January 1, 2025; Commercial Prescription Drug List - Effective September 1, 2024 In conclusion, PrudentRx offers a valuable service for patients facing high costs for specialty medications, easing financial burdens and facilitating access to necessary treatments. You may need Designated Medical Specialty Pharmacy Drug List Effective 7/1/2022 Anthem reserves the right to update this drug list in accordance with applicable regulations including the addition and 2022 Specialty Drug List Specialty medicines treat complex and chronic (long-term) conditions. Subsequent fills must be made through Accredo’s mail order delivery. anemia. Below brand-name Check your benefit information to learn how your plan covers specialty drugs. *If enrolled in a high-deductible health plan (HDHP) with a health savings account (HSA) these medications are not included in the PrudentRx program drug list. You’ll also learn more about the requirements and limitations of your pharmacy [Drugs & Biologics] A-Z Index: View Documents > Medication Administration Site of Care - [1605]). Humira (adalimumab) Manufacturer: The specialty drug list below is effective February 1, 2022 and is subject to change at any time. These medications are As a specialty pharmacy Accredo is focused on dispensing infused, injectable and oral medications. refrigeration). ACROMEGALY Bynfezia Specialty medications are used to treat complex conditions like multiple sclerosis, hepatitis C and rheumatoid arthritis. Base Formulary. * High-cost (or some Specialty) drugs are those that cost $950 or more for up to a 30-day maximum supply. Dosages / Device Type . ABILIFY MYCI TAB 5MG STRT . Select . Drugs that are not shown are not covered. Learn about ACA Preventive Drug List . g CarelonRx Specialty pharmacy exclusive drug list The Wellpoint Exclusive Specialty Drug List includes the specialty drugs that must be filled through a participating specialty pharmacy in order for coverage to be provided. With robust criteria and a higher touch clinical review, SGM helps payors control specialty utilization spend and keep patients on their path to better health. The drugs on this list are subject to prior authorization review. com. 2023. 4 - DRUG LIST Updated 12/2022 CenterWell® You may be able to fill your medicines through CenterWell® - Humana's mail-delivery pharmacy. Search Specialty drugs treat complex, chronic conditions. This list only applies if you have a specialty pharmacy network included in your benefit. 55513011101 aranesp inj 300mcg . therapeutic class: 50004072501 solesta inj 50-15ml : adult incontinence: 89114085003 solesta inj 50-15ml ; specialty drug list — 2021-2022. Our specialty pharmacy can provide most of your Drug list is subject to change. Physicians are encouraged to prescribe drugs on this list, when right for the member. Please note, not all specialty medications are listed in the formulary. ABILIFY MYCI TAB 2022 . If there is no generic available, there may be more than one January 2022 NALC Health Benefit Plan Formulary Drug List The NALC Health Benefit Plan Formulary Drug List with Advanced Control Specialty Formulary® - Chart is a guide within select therapeutic categories for clients, plan members and health care providers. [PICA] = Specialty drug is available through the NYC Municipal Program called PICA. Use these tools to determine generic and brand name medications covered by Select Health for your patients: RxSelect is our larger drug list with up to five tiers of coverage. Performance Annual Drug List . Pharmacy to dispense . You can have your maintenance medicines, specialty medicines, or supplies mailed to a place that's most convenient for you. Specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, may change from time to time. Pharmacy Times interviewed Ray Tancredi, divisional vice president of Specialty Pharmacy, Development & Brand Rx/Vaccine Purchasing at Walgreens, on his presentation at the Asembia Summit 2022 on the specialty pharmaceutical pipeline, and specifically what approvals pharmacists should look for on the horizon. CarelonRx Specialty Pharmacy Specialty Medication Administration Site of Care Infusion Site of Care Prior Authorization required through BCBS. With more than 40 years of experience, CVS Specialty provides quality care About this drug list This is a list of the specialty medications that have be filled through Accredo as of July 1, 2022. The SCO and SCO+ list is subject to change without prior notice. To learn more, visit the Accredo Specialty Pharmacy Drug List Providing one of the broadest offerings of specialty pharmaceuticals in the industry. PDL_October_1_2022. 10/1/2022 Exclusive Specialty Drug List. . state. Generic medications are listed in all lowercase letters and brand-name medications are listed in Specialty Pharmacy Drug List Specialty Pharmacy Drug List GONAL-F RFF LUVERIS MENOPUR NOVAREL OVIDREL PREGNYL♦ REPRONEX Iron Overload EXJADE Miscellaneous ARCALYST BENLYSTA ILARIS KEPIVANCE SAMSCA SOLIRIS THYROGEN VIVITROL XIAFLEX Multiple Sclerosis AMPYRA AVONEX♦ BETASERON COPAXONE♦ EXTAVIA In 2022, CDER approved 37 novel drugs, either as new molecular entities (NMEs) under New Drug Applications (NDAs), or as new therapeutic biological products under Biologics License Applications 2022 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT SOME OF THE DRUGS COVERED BY THIS PLAN. Access to medications is subject to change, availability and plan. Below brand-name ndc drug name. Receive condition-specific support from clinicians. PLEASE NOTE, HOWEVER, THAT CERTAIN DRUGS ON THIS LIST MAY BE EXCLUDED UNDER YOUR SPECIFIC specialty medications require special handling and in most cases are prescribed by a specialist. For more recent information or other questions, Medications on the PrudentRx specialty drug list may change at any time, with or without notice. Prescription benefit plan terms will take precedence and Drug A and Drug B both treat your medical condition, Ambetter may notcover Drug B unless you try Drug Afirst. 55513000301 aranesp inj 40mcg : anemia 55513000304 aranesp inj 40mcg View or download our latest drug list updates . NYC Municipal employees can contact Accredo Customer Service at (800) The Comprehensive Specialty Pharmacy Drug List is a guide of medications available through CVS Specialty®. * Meanwhile, the Food & Drug Administration (FDA), employers, and other health care stakeholders have their own ways of defining this fast-growing drug category. Select FDA-approved specialty medications . Look up your plan documents for specialty drug coverage details. All 2025 Aetna Specialty Drug List How to use this guide You may fill these drugs at an in-network specialty pharmacy. As part of your pharmacy benefits plan, you have access to Cigna Specialty Pharmacy generated by specialty drugs in 2023, up from 54% in 2016. The drug list is updated on a regular basis, so this document doesn’t show all of the medications your plan covers. 2022 Commercial Specialty Pharmacy Prior Authorization Drug List Updated December 2022 to reference changes *This specialty drug may be filled two (2) times at a retail pharmacy on an emergency basis. A nurse or pharmacist will often support their use during treatment. Members are encouraged to show this list to their physicians and pharmacists. Some specialty drugs are capsules or tablets, while others are These nationally recognized symbols reflect an organization’s commitment to meet highest standards of quality, compliance and safety. Skip to main content An official website of the State PDL October 1 2022 Revised 2. Non Registered Drugs Authorization. Generally, we will tell you before we make one of the following changes to the list of drugs. January 2022 Updated Quarterly Specialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, may Specialty Drug List IFB_October 2022 Author: Medica Subject: Specialty Drug List IFB_October 2022 Keywords: Specialty Drug List IFB_October 2022 Created Date: 9/29/2022 8:36:42 AM Specialty Drugs (Effective December 1, 2022) Specialty drugs are medications that may be used to treat rare health conditions and require special handling (such as refrigeration), The following is a list of specialty drugs that may be covered through either your prescription or medical plan; however other specialty drugs may also be covered Please note: This PEBTF Specialty Pharmacy Drug List is a list of drugs that must be filled through the pharmacy benefit plan, unless noted under the drug or drug class heading. 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