Drugs Requiring Prior Approval
Some prescription drugs may require certification, also known as prior authorization, in order to be covered. These drugs have detailed criteria that must be met before prior authorization can be granted.
If the drug you are looking for is not listed in the chart below, please check Drugs Requiring Step Therapy and Drugs Subject to Quantity Limits. Below is a chart of the drugs and drug classes that require prior authorization, the prior authorization policies and the fax forms:
Drugs Requiring Prior Authorization |
Prior Authorization Policies |
Prior Authorization Review Form |
|---|---|---|
Alpha Interferons |
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Antifungal Agents |
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Antinarcoleptic Agents |
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Drugs Requiring Prior Authorization |
Prior Authorization Policies |
Prior Authorization Review Form |
|---|---|---|
COX2 Inhibitors |
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Fentanyl |
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Fertility Agents |
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Growth Stimulating Drugs |
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Immunomodulators |
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Multiple Sclerosis Agents |
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Omalizumab |
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Psoriasis Treatment Agents |
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Drugs Requiring Prior Authorization |
Prior Authorization Policies |
Prior Authorization Review Form |
|---|---|---|
Rheumatoid Arthritis Agents |
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Sildenafil and Tadalafil |

