Transcription of Self-Administered Specialty Drugs
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Self-Administered Specialty Drugs
Self-Administered Specialty Drugs *. Current 4/1/19. Newly marketed prescription medications may not be covered until the Pharmacy & Therapeutics Committee has had an opportunity to review the medication to determine if the medication will be covered and if so, which tier will apply based on safety, efficacy, and the availability of other products within that class of medications. The current list of newly marketed Drugs can be found on our New to Market Drug list. Important: Prior Authorization requirements may vary. Certain Drugs may not be covered by certain member plans. Refer to the member's individual policy for inclusion in the PA program and medication guide for determination of coverage. Member cost share may be higher for Self-Administered Specialty Drugs not obtained at an in-network Specialty pharmacy.
Follistim AQ PA PA Forteo PA, QL Fulphila1 PA 2 Fuzeon PA, QL PA, QL GalafoldLDD, PA PA, Gammagard1 1 PA LDD Gammaked1 PA PA Gamunex C1 PA PA Ganirelix PA LDD GattexLDD, PA, QL PA Gavreto LDD, PA 1 Genotropin PA LDD Gilenya PA,QL GilotrifLDD, PA, QL glatiramer 1 PA, QL Glatopa PA, QL PA Gleevec PA, QLPA, QL Gleostine Gonal-F PA Granix1 PA, QL ...
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