Transcription of 2018 National Formulary - Southern Scripts, LLC
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2018 National Formulary - Southern Scripts, LLC
2018 National Formulary Effective 01/01/2018 The Formulary List is a guide providing tier designation for common medicines within select therapeutic categories. The Formulary List may not include all drugs covered by your prescription drug benefit. Generic medicines are available within many of the therapeutic categories listed, in addition to categories not listed, and should be considered as the first line of prescribing. For benefit coverage or restrictions please check your benefit plan document(s). This listing is revised periodically as new drugs and new prescribing information becomes available. It is recommended that you bring this list of medications when you or a covered family member sees a physician or other healthcare provider. Tier Definitions 1 Generics 2 Preferred Brands 3 Non-Preferred Brands (ST) Step Therapy (PA) Prior Authorization (SP) Specialty Drugs Major Drug Class Overview Non-Preferred and Excluded* Drugs With Preferred Options 2018 Preferred Non-Preferred / Excluded * Drug Class ANALGESICS EUFLEXXA, GEL-ONE, HYALGAN, MONOVISC, ORTHOVISC GELSYN-3, SUPARTZ FX, SYNVISC, SYNVISC-ONE ANTIARTHRITICS ABSTRAL, EMBEDA, KADIAN, ZOHYDRO ER fentanyl, fentanyl citrate, morphine sulfate er, oxycodone hcl, FENTORA, HYSINGLA ER, NUCYNTA ER, OXYCONTIN NARCOTICS ANTI-INFECTIVES REBETOL moderiba, ribapak, ribavirin, ribavirin ANTIVIRALS DAKLINZA*, EPCLUSA*, HARVONI*, SOVALDI*, TECHNIVIE*, VIEKIRA PAK* MAVYRET, ZEPATIER HEPATITIS C DOXYCYCLINE
2018 National Formulary Effective 01/01/2018 The Formulary List is a guide providing tier designation for common medicines within select therapeutic categories.
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