Medical Drug Policies for Prior Authorization
- Actemra (tocilizumab) Intravenous RX
- Acute Hereditary Angioedema Products RX
- Adakveo (crizanlizumab-tmca) RX
- Alpha1 Proteinase Inhibitors RX
- Antihemophilic Factor Products RX
- Apretude (Cabotegravir) RX
- Benlysta (Belimumab) RX
- Botulinum Neurotoxins RX
- Briumvi RX
- Casgevy RX
- Cimzia RX
- Duchenne Musclar Dystrophy Drug Therapies RX.PA.009
- Eculizumab & Ravulizumab Products RX
- Encelto (revakinagene taroretcel-lwey) RX
- Enjaymo RX
- Entyvio (vedolizumab) RX
- Evkeeza RX
- Exondys 51 (eteplirsen) RX
- Gamifant RX
- Hemgenix RX
- Hereditary Angioedema (HAE) Prophylaxis Products RX
- Hyaluronic Acid Products RX
- Intravenous Immune Globulin (IVIG), Intramuscular (IM) & Subcutaneous Immune Globulin (SCIG) RX
- Infliximab Products RX
- Kisunla (donanemab) RX
- Krystexxa RX.PA.020
- Lenmeldy RX
- Leqvio (Inclisiran) RX
- Luteinizing Hormone Releasing Hormone (LHRH) agents RX
- Medical Drug Step Therapy RX
- Natalizumab Product RX
- Neonatal Fc Receptor (FcRn) Antagonists RX
- Niktimvo (axatilimab-csfr) RX
- Nucala (mepolizumab) RX
- Nulojix (Belatacept) RX
- Ocular Disorders RX
- Ocrelizumab Products RX
- Qalsody RX.PA.096
- Qutenza RX.PA.097
- Rituximab products RX
- Roctavian RX.PA.084
- Ryplazim RX.PA.067
- Saphnelo (Anifrolumab-fnia) RX
- Skyrizi (risankizumab-rzaa) RX
- Specialty Drug Management RX
- Specialty Enzyme Replacement Therapy (ERT) RX.PA.062
- Spinraza (Nusinersen) RX
- Sunlenca RX
- Tezspire (Tezepelumab) RX
- Tocilizumab Products RX
- Tryngolza (olezarsen) RX
- Tzield RX
- Ultomiris (ravulizumab-cwvz) RX
- Ustekinumab Products RX
- Visudyne (verteporfin) RX
- Vyepti (eptinezumab) RX
- Xenleta (Lefamulin) RX
- Xolair (Omalizumab) RX
- Zinplava (bezlotoxumab) RX
- Zolgensma (onasemnogene) RX
- Zyntelgo RX