Prescription Drug Policies
View our plain language policies below
- AAT Deficiency
- Actemra - Tocilizumab
- Actimmune - Interferon Gamma-1b
- Acute Oral CGRP Antagonist Therapies
- Adakveo - Crizanlizumab
- Adcirca - Tadalafil
- Additional Quantities Requests
- Adempas - Riociguat
- Aldurazyme - Laronidase
- Altabax - Retapamulin Step - Edit
- Ankylosing Spondylitis Immunomodulator Therapies
- Anticoagulant Novel Savaysa Step - Edit
- Antifungals Topical Step - Edit
- Apokyn - Apomorphine Hydrochloride and Kynmobi - Apomorphine Hydrochloride
- Aptiom Step Edit
- ARB - Angiotensin II Receptor Blocker - Generic First Step Edit
- Arcalyst - Rilonacept
- Arikayce -amikacin liposomal
- Austedo -deutetrabenazine
- Azelaic Acid
- Behavioral Health
- Benlysta -belimumab
- Bisphosphonate - Oral Step-Edit
- Botox -onabotuliumtoxin A
- Brineura -cerliponase alfa
- Briviact -brivaracetam Step-Edit
- Bronchitol (mannitol)
- Carbaglu -carglumic acid
- Cayston -aztreonam
- Cerdelga -Eiglustat Tartrate
- Cerezyme -imiglucerase
- Cholbam -cholic acid
- Cinqair -Reslizumab
- Contraceptive Coverage Under Preventative Health Services in Wellness Benefit
- Corlanor -ivabradine
- Cresemba -isavuconazonium sulfate
- Crohns Disease Immunomodulator Therapies
- Crotan -crotamiton
- Crysvita -burosumab
- Cytogam -cytomegalovirus immune globulin- human
- Dalfampridine
- Daliresp -roflumilast
- Denavir -penciclovir cream Step-Edit
- Diabetes Drug Therapies
- Doptelet - avatrombopag
- Doxercalciferol
- Dupixent -dupilumab
- Dyanavel XR -amphetamine ER Suspension
- Dysport -abobotulinumtoxin A
- Egrifta -tesamorelin acetate
- Elaprase -idursulfase
- Elelyso -taliglucerase alfa
- Emflaza -deflazacort
- Ensspryng -satralizumab
- Entyvio -vedolizumab
- Epidiolex -cannabidiol
- Erectile Dysfunction Medications
- Esbriet -pirfenidone and Ofev -nintedanib esylate
- Eucrisa -crisaborole
- Evenity -romosozumab
- Evkeeza (evinacumab)
- Evrysdi -risdiplam
- Excluded Drug List
- Exjade - Deferasirox and Jadenu - Deferasirox
- Experimental Medications
- Fabrazyme -agalsidase beta
- SGLT2 Non Diabetes Medications
- Fasenra - Benralizumab
- Fentanyl Breakthrough Pain
- Ferriprox - Deferiprone
- Fintepla - Fenfluramine
- Fish Oil - Lovaza
- Flector Patch - Diclofenac Transdermal
- Flolan - Epoprostenol
- Forteo - Teriparatide
- Gabapentin Extended Release - Gralise and Horizant
- Galafold - Migalastat
- Gamifant - Emapalumab
- Gattex - Teduglutide
- Givlaari - Givosiran
- Growth Hormone
- H P Acthar Gel - corticotropin
- Hepatitis B Treatment - Hepsera - Baraclude and Vemilidy
- Hepatitis C Treatment
- Hereditary Angioedema
- Humira - Adalimumab
- Ilaris - Canakinumab
- Impavido - Miltefosine
- Inbrija - Levodopa Inhalation Powder
- Increlex -mecasermin
- Infertility Medications - Illinois
- Ingrezza -valbenazine
- Isbrela – tenapanor
- Isotretinoin Oral
- Isturisa (osilodrostat)
- IVIG
- Jakafi -ruxolitinib
- Jublia -efinaconazole and Kerydin -tavaborole
- Juxtapid -lomitapide
- Jynarque -tolvaptan
- Kalydeco -ivacaftor
- Kanuma -sebelipase alfa
- Keveyis -dichlorphenamide
- Kineret -anakinra
- Klisyri -tirbanibulin-
- Korlym -mifepristone
- Krystexxa -pegloticase
- Kuvan -sapropterin
- Lemtrada -alemtuzumab
- Letairis -ambresentan
- Leuprolide Acetate -Fensolvi - Lupron Depot - Lupron Depot-Ped - Leuprolide acetate - Lupaneta
- Livmarli – maralixibat
- Lokelma -sodium zirconium cyclosilicate
- Lonhala Magnair (glycopyrrolate)
- Lumizyme -alglucosidase
- Lupkynis -voclosporin
- Luxturna -voretigene neparvovec
- Makena -hydroxyprogesterone caproate
- Mandatory Generic Override Review
- Mavenclad -cladribine
- Illinois Medical Exception Process
- Medical Exception for Non-Covered Glucose Test Strips
- Medical Exception for Preferred BrandCopayment
- Medication Refill Threshold and Early Refill Exceptions Policy
- Mepsevii
- Migranal -dihydroergotamine mesylate Nasal Spray
- Mirvaso -brimonidine tartrate Gel
- Mozobil -plerixafor
- Mulpleta -lusutrombopag
- Myalept -metreleptin
- Myobloc -rimabotulinumtoxin B
- Mytesi -crofelemer
- Naglazyme -galsulfase
- Newly Approved Medications, Products, & Indications
- Nexletol -bempedoic acid and Nexlizet -bempedoid acid-ezetimibe
- Non Preferred ICS-LABA Combination Inhalers
- Non-Preferred ICS Inhalers
- Northera -droxidopa
- Nourianz -istradefylline
- Nplate -romiplostim
- Nucala -mepolizumab
- Nuplazid
- Ocaliva -obeticholic acid
- Ocrevus - ocrelizumab
- Oncology Regimen Review
- Ongentys
- Onpattro -patisiran
- Opioids -Long Acting and Short Acting
- Opioid Partial Agonists Reverse Edit Policy
- Opsumit -macitentan
- Opzelura – ruxolitinib
- Orenitram -treprostinil diolamine
- Orfadin -nitisinone and Nityr -nitisinone
- Oriahnn (elagolix, estradiol, and norethindrone)
- Orilissa -elagolix
- Orkambi -lumacaftor-ivacaftor
- Otezla -apremilast
- Oxbryta -voxelotor
- Oxervate -cenegermin
- Palforzia -peanut allergen powder
- Palynziq -pegvaliase-pqpz
- Paricalcitol Capsule Step-Edit
- Phenoxybenzamine
- Photrexa Viscous - Riboflavin 5 Phosphate
- Plaque Psoriasis Immunomodulator Therapies
- Polyarticular Juvenile Idiopathic Arthritis Immunomodulator Therapies
- PPI - Proton Pump Inhibitor - Coverage
- Pretomanid
- Prevymis - letermovir
- Promacta - eltrombopag
- Prophylactic Injectable Calcitonin Gene-Related Peptide - CGRP - Inhibitor Therapies
- Psoriatic Arthritis Immunomodulator Therapies
- Pulmozyme - dornase alfa
- Qbrexza - glycopyrronium
- QHP - Coverage of Erectile Dysfunction Drugs
- Qudexy XR - topiramate ER - and Trokendi XR - topiramate ER
- Quillichew - methylphenidate HCl chew tab - ER
- Quillivant XR - methylphenidate HCL susp
- Radicava -edaravone
- Rayaldee -calcifediol
- Reblozyl -luspatercept
- Regranex -becaplermin
- Relistor -methylnaltrexone bromide
- Remicade -infliximab - Inflectra -infliximab -and Renflexis -infliximab
- Remodulin -treprostinil
- Revatio -sildenafil
- Revcovi -elapegademase
- Reyvow -lasmiditan
- Rheumatoid Arthritis Immunomodulator Therapies
- Rhofade -oxymetazoline
- Ribavirin Oral Inhalation
- Rituxan -rituximab
- Ruzurgi -amifampridine
- Sabril -vigabatrin
- Samsca -tolvaptan
- Sandostatin -octreotide and Sandostatin LAR -octreotide
- Savella -milnacipran
- Scenesse -afamelanotide-
- Sensipar -cinacalcet
- Signifor and Signifor LAR -pasireotide
- Sirturo -bedaquiline
- Soliris -eculizumab
- Somatuline Depot -lanreotide acetate
- Somavert -pegvisomant
- Soolantra -ivermectin
- Spinraza -nusinersen
- Spravato -esketamine
- Spritam -levetiracetam ODT Step-Edit
- Statin -HMG CoA reductase inhibitor - Brand Name
- Strensiq - asfotase alfa
- Sucraid -sacrosidase
- Sunosi -soriamfetol
- Supprelin LA -histrelin acetate
- Symdeko -tezacaftor-ivacaftor
- Synagis -palivizumab
- Synarel
- Syprine -trientine hydrochloride
- Tavalisse -fostamatinib
- Tazorac - tazarotene
- Tegsedi -inotersen
- Tepezza - teprotumumab
- Testosterone -Implantable -Topical -Oral -and Nasal
- Thiola -tiopronin
- Tobi-tobramycin -Bethkis-tobramycin -Kitabis Pak-tobramycin - Tobramycin Compound for Inhalation
- Topical Vitamin D3 - Taclonex and Vectical Step Edit
- Tracleer -bosentan
- Trikafta -elexacaftor-tezacaftor-ivacaftor
- Triptan Managed Dose Limit
- Triptodur -triptorelin
- Tymlos -abaloparatide
- Tysabri -natalizumab
- Tyvaso -treprostinil
- Uceris -budesonide
- Ulcerative Colitis Immunomodulator Therapies
- Ultomiris -ravulizumab
- Uplizna -inebilizumab
- Uptravi -selexipag
- Veletri -epoprostenol
- Veltassa -patiromer
- Verquvo (vericiguat)
- Ventavis -iloprost
- Viberzi
- Vimizim -elosulfase alfa
- VPRIV -velaglucerase alfa
- Vyndaqel-Vyndamax -tafamidis meglumine
- Vyvanse -lisdexamfetamine Chewable
- WA Medical Exception Process
- Wakix -pitolisant
- Weight Loss Medications
- Wellness Coverage for HIV Medications Used for PrEP
- Wellness Coverage for Statin Medications -HMG CoA reductase inhibitors
- Winlevi -clascoterone-
- Xcopri -cenobamate
- Xenazine -tetrabenazine
- Xeomin -incobotulinumtoxin A
- Xepi -ozenoxacin Step-Edit
- Xiaflex -collagenase clostridium histolyticum
- Xifaxan -rifaximin
- Xolair -omalizumab
- Xuriden -uridine triacetate
- Xyrem -sodium oxybate
- Yupelri
- Zavesca -miglustat
- Zoladex
- Zolgensma -onasemnogene abeparvovec