For members enrolled in an
AmeriHealth prescription drug program, prior authorization requirements will be
applied to certain drugs. The purpose of prior authorization is to ensure that
drugs are medically necessary and are being used appropriately. The most recent
updates are reflected below.
Drugs requiring prior
authorization
The prior authorization
requirement for the following non-formulary drugs was effective at the time the
drugs became available in the marketplace:
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CometriqTM
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Not available
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Cancer & Organ Transplant
Drugs
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January 17, 2013
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Eliquis?
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Not available
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Heart, Blood Pressure, &
Cholesterol
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January 4, 2013
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Gattex?
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Not available
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Stomach, Ulcer, & Bowel Meds
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January 25, 2013
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IclusigTM
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Not available
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Cancer & Organ Transplant
Drugs
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December 28, 2012
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JuxtapidTM
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Not available
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Heart, Blood Pressure, &
Cholesterol
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January 17, 2013
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Xeljanz?
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Not available
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Bone, Joint, & Muscle
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November 30, 2012
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The following non-formulary drugs have
been added to the list of drugs requiring prior authorization.
Members
taking these drugs prior to the effective date are not affected.
Effective July 1, 2013.
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Actoplus Met? XR
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Not available
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Diabetes, Thyroid, Steroids, &
Other Miscellaneous Hormones
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Dolophine?
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Not available
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Pain, Nervous System, &
Psych
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Vascepa?
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Not available
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Heart, Blood Pressure, &
Cholesterol
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