ACA 5-Tier Drug List

ACA 5-Tier Drug List
For Individual PPO and Small Group HMO, POS, and PPO
plans (including Marketplace/QHP plans) with ACA-compliant
coverage becoming effective on or after January 1, 2014
Effective January 1, 2014
What is the Drug List?
Also called a “formulary” by doctors and
pharmacists, the Drug List is an extensive list of safe
and effective, FDA-approved, brand name and
generic prescription drugs used to treat the most
common medical conditions.
The Health First Pharmacy and Therapeutics
Committee (P&T), a panel of physicians and
pharmacists, developed our Drug List and updates it
regularly. The list includes quality drugs available to
you at reasonable cost. Only those medications that
have successfully passed federally required clinical
testing and evaluation and have been proven
effective are included. The Pharmacy and
Therapeutics Committee reviews and evaluates all
available literature about a drug when updating the
list.
About tiers
Most covered prescription drugs will be categorized
into one of five tiers. The cost of drugs varies
widely, even though several different medications
may be used to treat the same condition. What you
pay for the prescription depends upon what tier the
drug is listed in. Health First offers many benefit
plans that can vary in coverage for each tier. Details
about your specific benefit for each tier are included
in the Health First Summary of Benefits.
• Tier 1 — Preferred Generic Drugs
• Tier 2 — Non-Preferred Generic Drugs
• Tier 3 — Preferred Brand Name Drugs and
some generics
• Tier 4 — Non-Preferred Brand Name Drugs and
some generics (limited to a 30-day supply)
• Tier 5 — Specialty Drugs (limited to a 30-day
supply, must obtain from Health First Family
Pharmacy)
Generic drugs are prescription drugs that are
identified by their chemical name. When the patent
has expired on a brand name drug, the FDA permits
new manufacturers to create an equivalent of the
brand name drug and make it available to the public.
Updated January 1, 2014
Generally, more than one manufacturer will create
generic versions, although often the same
pharmaceutical firm that produces the brand name
drug also makes the generic version. This prompts
competitive pricing of the generic version and
usually results in a less expensive drug.
The Drug List is subject to change
In order to continue to offer a safe and cost effective
selection of prescription drugs, Health First
periodically makes changes to the Drug List. These
changes may include removing medications, adding
restrictions, and/or covering a drug at a higher tier.
The following list represents some of the most
common scenarios in which changes to drug
coverage will occur:
• Throughout the year, new medications are
approved by the FDA. It is the policy of Health
First that new drugs will be excluded for 6 months
from the date of FDA approval, during which time
the Health First Pharmacy and Therapeutics
Committee can review the drug for safety and
efficacy.
• The Drug List may change when a medication is
withdrawn from the market due to safety reasons
or if it becomes available over-the-counter (OTC).
At the time that a medication on the Health First
Drug List becomes available OTC, it may be
excluded from coverage from that point forward.
• When a brand-name prescription drug loses its
patent and the equivalent generic form is added to
the Drug List, the brand-name drug may be
moved to the highest non-specialty drug tier,
which is generally Tier 4 or removed from the
formulary.
This formulary is current as of January 1, 2014. To
get updated information about covered drugs, please
visit our Web site at HealthFirstHealthPlans.org or
call Customer Service toll-free Monday through
Friday, 8am–8pm, and Saturday, 8am–Noon:
• For HMO and POS members: 1-800-716-7737
• For PPO members: 1-855-443-4735
Health First—ACA 5-Tier Drug List
•
TTY/TDD relay 1-800-955-8771
Are there any restrictions on my
coverage?
Some covered drugs may have additional
requirements or limits on coverage. These
requirements and limits may include:
• Prior Authorization: Health First requires you
and/or your physician to get prior authorization
for certain drugs. This means that you will need to
get approval from us before you fill your
prescriptions. In order for the plan to pay for these
drugs, the physician ordering the prescription is
required to submit all medical information to
Health First documenting the medical necessity.
These drugs are identified in the Drug List.
• Step Therapy: In some cases, Health First requires
you to first try certain drugs to treat your medical
condition before we will cover another drug for that
condition. For example, if Drug A and Drug B both
treat your medical condition, we may not cover
drug B unless you try Drug A first. If Drug A does
not work for you, we will then cover Drug B. Please
see the reference table on page 9 for a complete
listing of the drugs which currently require step
therapy.
• Quantity Limits: For certain drugs, Health First
limits the amount of the drug that Health First will
cover. For example, Health First provides 30 tablets
per prescription for Pradaxa. This may be in
addition to a standard one month or three month
supply.
How can I make the most of my
prescription drug benefit?
Prescription drug costs continue to rise every year and
can represent a significant part of your healthcare
expenses. Health First can help you pay for your
medications by sharing the cost with you and
providing substantial discounts for medications you
purchase. To help you manage your drug costs, here
are some money-saving tips to consider:
• Use Tier 1 generic medications whenever
possible. Generic drugs are the chemical equivalent
of brand-name drugs, and are just as effective in
most cases. If you take generic drugs you will
generally pay less, so talk to your doctor about
switching to a generic equivalent of any brandname you are taking if it is appropriate. In addition,
Page 2
many of our prescription drug riders include a $2
copayment for Tier 1 generic drugs ensuring
affordable access to many commonly prescribed
medications. Please see the list of drugs below to
determine which drugs are included in Tier 1.
• See if your prescription pills can be split in half
For some medications, pills may be available in
different strengths but still have the same price. If
you need one of these select medications, your
doctor may be able to write your prescription so that
you can get your pills at double strength, but half of
the number of pills you’d normally need, and you’d
only pay half of the regular price. Then you’d split
them in half, so you’d get the proper dose—saving
up to 50 percent of the cost! The drugs that may be
eligible for the Pill-Splitting program are marked
with the symbol (1/2) on the drug list, so review this
information with your doctor if your drug qualifies.
What if my drug is not on the Formulary?
If your drug is not included in this formulary, you
should first contact Customer Service and confirm that
your drug is not covered. If you learn that Health First
does not cover your drug, you have two options:
• You can ask Customer Service for a list of similar
drugs that are covered by Health First. When you
receive the list, show it to your doctor and ask him
or her to prescribe a similar drug that is covered by
Health First.
• You can ask Health First to make an exception and
cover your drug. See below for information about
how to request an exception.
• If Health First approves you or your physician’s
request for an exception to the Health First
formulary the approved drug will be covered at the
Tier 4 cost share. If the cost of the medication is
greater than $500 per month it will be covered at
the T5 or Specialty Tier.
Excluded drugs
Health First does not provide coverage for all drugs.
In addition to the drugs marked “excluded” in this
drug list, newly FDA approved drugs are not covered
unless the P & T Committee in its sole discretion
approves these drugs for coverage. Health First will
automatically exclude a particular drug if a generic
version becomes available and an entire class of
drugs if a particular drug within that class becomes
available over the counter.
Health First—ACA 5-Tier Drug List
Page 3
Health First Formulary
The formulary that begins on the next page
provides coverage information about some of the
drugs covered by Health First. If you have trouble
finding your drug in the list, turn to the Index that
begins on page 65. The first column of the chart
lists the drug name. Brand name drugs are
capitalized (e.g., PRADAXA) and generic drugs
are listed in lower-case italics (e.g., lisinopril).
The information in the Requirements/Limits
column tells you if Health First has any special
requirements for coverage of your drug.
SP: Specialty Pharmacy. This prescription may
be available only at certain pharmacies. For more
information consult your Pharmacy Directory or
call Customer Service at the numbers listed above.
PA: Prior Authorization. Health First requires
you or your physician to get prior authorization for
certain drugs. This means that you will need to get
approval from Health First before you fill your
prescriptions. If you don't get approval, Health First
may not cover the drug.
QL: Quantity Limit may also be listed. (For
example, “30/30 days” would mean your coverage
of this drug is limited to 30 pills every 30 days.)
Prescriptions written for more than the suggested
Quantity Limits will only be honored up to the
listed amount.
ST: Step Therapy. In some cases, Health First
requires you to first try certain drugs to treat your
medical condition before we will cover another
drug for that condition. For example, if Drug A and
Drug B both treat your medical condition, Health
First may not cover drug B unless you try Drug A
first. If Drug A does not work for you, Health First
will then cover Drug B.
1/2: You may be able to split these pills in half.
Begin by asking your doctor if pill-splitting is right
for you. If so, ask your doctor to write your
prescription for half the number of pills and double
the strength you normally need. For example,
instead of 30 pills of 20 mg, you’d get a
prescription for 15 pills of 40 mg. Then you (or the
pharmacy) can split them in half for the correct
dose. This way, you save 50 percent of the cost.
Call our Customer Service Department for details.
MD: Maintenance Drug. You may be taking these
drugs on a long-term basis. Maintenance
medications are generally those used to treat
chronic conditions and long-term conditions.
For information about a specific drug not listed, please contact Customer Service. Health First Customer
Service is available Monday–Friday, 8am–8pm, and Saturday, 8am–Noon. TTY is available during the same
hours.
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For HMO and POS members — (800) 716-7737
For PPO members — (855) 443-4735
TDD/TTY relay — (800) 955-8771
E-mail — [email protected]
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
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Contraceptive coverage Beginning August 1, 2012, members are eligible to receive the following prescription contraceptives with no
cost share due to the preventive care provisions of the Affordable Care Act.
ƒ NECON 0.5/35-28
ƒ NECON 1/35-28
ƒ NORTREL 0.5/35 (28)
ƒ NORTREL 1/35 (21)
ƒ NORTREL 1/35 (28)
ƒ CYCLAFEM 1/35
ƒ ALYACEN 1/35
ƒ LOW-OGESTREL
ƒ CRYSELLE-28
ƒ NORGESTREL/ETHINYL ESTRADIOL
ƒ NECON 7/7/7
ƒ NORTREL 7/7/7
ƒ CYCLAFEM 7/7/7
ƒ ALYACEN 7/7/7
ƒ TRI-SPRINTEC
ƒ TRINESSA
ƒ TRI-PREVIFEM
ƒ NORGESTIMATE/ETHINYL ESTRADIOL
If you have any questions regarding your eligibility for preventive contraceptive coverage, please contact your
employer or Health First’s Customer Service Department Monday–Friday, 8am–8pm, and Saturday, 8am–
Noon.
ƒ For HMO and POS members — (800) 716-7737
ƒ For PPO members — (855) 443-4735
ƒ TDD/TTY relay — (800) 955-8771
ƒ E-mail — [email protected]
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
ADHD/Anti-Narcolepsy/Anti-Obesity/Anorexiants
Amphetamines
Amphetamine Mixtures
amphetamine-dextroamphetamine
Amphetamines
dextroamphetamine sulfate oral tablet 10 MG, 5 MG
methamphetamine hcl
VYVANSE
Attention-Deficit/Hyperactivity Disorder (ADHD) Agents
ADHD Agent - Selective Alpha Adrenergic Agonists
INTUNIV ORAL TABLET EXTENDED RELEASE 24 HR 1 MG, 2 MG, 3
MG
ADHD Agent - Selective Norepinephrine Reuptake Inhibitor
STRATTERA
Stimulants - Misc.
Stimulants - Misc.
CONCERTA ORAL TABLET EXTENDEDRELEASE 18 MG, 27 MG, 36
MG
dexmethylphenidate hcl
FOCALIN XR ORAL CAPSULE EXTENDED RELEASE 24 HOUR 10 MG,
15 MG, 20 MG, 25 MG, 30 MG
METHYLIN ORAL TABLET CHEWABLE
methylphenidate hcl oral solution
methylphenidate hcl oral tablet
NUVIGIL
PROVIGIL
Aminoglycosides
Aminoglycosides
Aminoglycosides
neomycin sulfate oral tablet
paromomycin sulfate oral
Analgesics - Anti-Inflammatory
Gold Compounds
Gold Compounds
RIDAURA
Interleukin-1 Blockers
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NOTES
T2
T2
T3
T4
ST
T4
PA
T4
PA
T3
ST
T3
T4
ST
T2
T2
T2
T4
T4
PA
PA
T4
T4
T3
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Interleukin-1 Blockers
ARCALYST
Interleukin-6 Receptor Inhibitors
Interleukin-6 Receptor Inhibitors
ACTEMRA INTRAVENOUS SOLUTION 80 MG/4ML
Nonsteroidal Anti-Inflammatory Agents (NSAIDS)
Cyclooxygenase 2 (Cox-2) Inhibitors
CELEBREX
Nonsteroidal Anti-Inflammatory Agents (NSAIDS)
diclofenac potassium oral tablet
diclofenac sodium oral tablet delayed release 50 MG, 75 MG
etodolac oral tablet
fenoprofen calcium oral tablet
flurbiprofen oral
ibuprofen oral tablet 400 MG
indomethacin oral capsule
ketoprofen oral
ketorolac tromethamine oral
meclofenamate sodium oral
mefenamic acid oral
meloxicam oral tablet
meloxicam oral suspension
nabumetone oral
naproxen oral tablet
naproxen sodium oral tablet 275 MG, 550 MG
oxaprozin
piroxicam oral capsule 20 MG
PONSTEL
sulindac oral
tolmetin sodium
Pyrimidine Synthesis Inhibitors
Pyrimidine Synthesis Inhibitors
leflunomide oral
Soluble Tumor Necrosis Factor Receptor Agents
Soluble Tumor Necrosis Factor Receptor Agents
ENBREL SUBCUTANEOUS KIT
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TIER
NOTES
T5
PA
T5
PA
T4
ST
T2
T3
T2
T4
T2
T1
T2
T2
T3
T4
T5
T1
T2
T3
T1
T2
T3
T3
T3
T2
T3
T3
T5
PA
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Analgesics - Nonnarcotic
Salicylates
Salicylates
diflunisal oral
Analgesics - Opioid
Opioid Agonists
Opioid Agonists
fentanyl transdermal
fentanyl citrate buccal lollipop
hydromorphone hcl oral tablet
levorphanol tartrate oral
meperidine hcl oral tablet 50 MG
methadone hcl oral tablet
morphine sulfate oral tablet
morphine sulfate er oral tablet extendedrelease
morphine sulfate er beads oral capsule extended release 24 hour 30 MG, 60
MG
NUCYNTA
NUCYNTA ER ORAL TABLET EXTENDED RELEASE 12 HR 100 MG,
150 MG, 200 MG, 250 MG
oxycodone hcl oral tablet 15 MG, 30 MG, 5 MG
oxymorphone hcl oral
oxymorphone hcl er oral tablet extended release 12 hr 15 MG, 7.5 MG
tramadol hcl oral tablet
tramadol hcl er oral tablet extended release 24 hr 100 MG, 200 MG
tramadol hcl er oral tablet extended release 24 hr 300 MG
Opioid Combinations
Opioid Combinations
oxycodone-ibuprofen
Opioid Partial Agonists
Opioid Partial Agonists
buprenorphine hcl sublingual tablet sublingual 8 MG
butorphanol tartrate injection solution 2 MG/ML
Androgens-Anabolic
Anabolic Steroids
Anabolic Steroids
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NOTES
T4
T4
T5
T2
T4
T2
T2
T2
T3
T5
PA
T4
T5
PA
PA
T2
T3
T3
T2
T3
T3
ST
T3
T4
T2
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
oxandrolone oral
Androgens
Androgens
ANDROGEL TRANSDERMAL GEL 20.25 MG/1.25GM (1.62%)
ANDROXY
danazol oral
DEPO-TESTOSTERONE INTRAMUSCULAR OIL 200 MG/ML
testosterone cypionate intramuscular
testosterone enanthate intramuscular
Anorectal Agents
Intrarectal Steroids
Intrarectal Steroids
COLOCORT
hydrocortisone re enema
Vasodilating Agents
Nitrate Vasodilating Agents
RECTIV
Anthelmintics
Anthelmintics
Anthelmintics
ALBENZA
BILTRICIDE
STROMECTOL
Antianginal Agents
Antianginals-Other
Antianginals-Other
RANEXA
Nitrates
Nitrates
DILATRATE-SR
isosorbide dinitrate oral tablet 10 MG, 20 MG, 30 MG, 5 MG
isosorbide dinitrate sublingual tablet sublingual 2.5 MG
isosorbide dinitrate er oral tablet extendedrelease
isosorbide mononitrate oral tablet 20 MG
NITROSTAT
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NOTES
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T3
T2
T3
T2
T2
ST
ST
T2
T2
T4
T3
T4
T3
T4
ST
T2
T2
T2
T2
T2
T3
Antianxiety Agents
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Antianxiety Agents - Misc.
Antianxiety Agents - Misc.
buspirone hcl oral tablet 10 MG, 5 MG, 7.5 MG
hydroxyzine hcl oral solution
hydroxyzine hcl oral tablet
hydroxyzine pamoate oral
meprobamate
Antiarrhythmics
Antiarrhythmics Type I-A
Antiarrhythmics Type I-A
disopyramide phosphate oral
NORPACE CR ORAL CAPSULE EXTENDED RELEASE 12 HOUR 150 MG
procainamide hcl injection
quinidine gluconate er
quinidine sulfate oral
quinidine sulfate er
Antiarrhythmics Type I-C
Antiarrhythmics Type I-C
flecainide acetate
propafenone hcl
Antiarrhythmics Type III
Antiarrhythmics Type III
amiodarone hcl oral tablet 200 MG, 400 MG
MULTAQ
TIKOSYN
Antiasthmatic And Bronchodilator Agents
Anti-Inflammatory Agents
Anti-Inflammatory Agents
cromolyn sodium inhalation
Bronchodilators - Anticholinergics
Bronchodilators - Anticholinergics
ipratropium bromide inhalation
SPIRIVA HANDIHALER
Leukotriene Modulators
5-Lipoxygenase Inhibitors
ZYFLO CR
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TIER
NOTES
T2
T2
T2
T2
T2
T2
T5
T3
T2
T2
T3
PA
T2
T2
T2
T4
T5
PA
T2
T2
T3
T4
ST
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Leukotriene Receptor Antagonists
zafirlukast
Steroid Inhalants
Steroid Inhalants
ASMANEX 120 METERED DOSES
ASMANEX 14 METERED DOSES
ASMANEX 30 METERED DOSES
ASMANEX 60 METERED DOSES
budesonide inhalation suspension 0.25 MG/2ML, 0.5 MG/2ML
FLOVENT DISKUS
FLOVENT HFA
PULMICORT FLEXHALER
Sympathomimetics
Adrenergic Combinations
ADVAIR DISKUS
ADVAIR HFA
DULERA
Beta Adrenergics
albuterol sulfate inhalation nebulization solution (2.5 MG/3ML) 0.083%, 1.25
MG/3ML
albuterol sulfate oral
ARCAPTA NEOHALER
BROVANA
FORADIL AEROLIZER
levalbuterol hcl inhalation nebulization solution 1.25 MG/0.5ML
MAXAIR AUTOHALER
metaproterenol sulfate oral syrup
metaproterenol sulfate oral tablet
PROVENTIL HFA
terbutaline sulfate oral
Mixed Adrenergics
epinephrine hcl injection solution 0.1 MG/ML
Xanthines
Xanthines
LUFYLLIN
theophylline er oral tablet extended release 12 hr
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T4
T4
T4
T4
T3
T4
T4
T4
T4
T4
T4
T2
T2
T4
T5
T4
T4
T4
T2
T3
T3
T3
PA
PA
PA
T3
T4
T3
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
theophylline er oral tablet extended release 24 hr
Anticoagulants
Coumarin Anticoagulants
Coumarin Anticoagulants
warfarin sodium oral
Direct Factor Xa Inhibitors
Direct Factor Xa Inhibitors
XARELTO
Heparins And Heparinoid-Like Agents
Heparins And Heparinoid-Like Agents
heparin sodium (porcine) injection solution 20000 UNIT/ML
Low Molecular Weight Heparins
enoxaparin sodium subcutaneous
Synthetic Heparinoid-Like Agents
fondaparinux sodium
Thrombin Inhibitors
Thrombin Inhibitors - Selective Direct & Reversible
PRADAXA
Anticonvulsants
Anticonvulsants - Misc.
Anticonvulsants - Misc.
BANZEL ORAL SUSPENSION
BANZEL ORAL TABLET 200 MG
BANZEL ORAL TABLET 400 MG
carbamazepine oral tablet
carbamazepine oral tablet chewable
gabapentin oral capsule
gabapentin oral tablet 800 MG
lamotrigine oral tablet 25 MG
lamotrigine oral tablet 100 MG, 150 MG, 200 MG
lamotrigine oral tablet chewable 25 MG, 5 MG
levetiracetam oral tablet
levetiracetam er oral tablet extended release 24 hr 750 MG
LYRICA ORAL CAPSULE
oxcarbazepine oral tablet
POTIGA
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T3
T2
T4
PA
T3
T5
PA
T5
PA
T3
PA
T4
T4
T5
T3
T3
T2
T2
T1
T2
T2
T2
T3
T4
T3
T5
PA
PA
PA
PA
PA
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
primidone oral
topiramate oral
VIMPAT ORAL
zonisamide
Carbamates
Carbamates
felbamate
GABA Modulators
GABA Modulators
GABITRIL ORAL TABLET 4 MG
SABRIL ORAL TABLET
Hydantoins
Hydantoins
DILANTIN ORAL SUSPENSION
PEGANONE
phenytoin sodium extended oral capsule 100 MG, 200 MG, 300 MG
Succinimides
Succinimides
CELONTIN
ethosuximide oral
Valproic Acid
Valproic Acid
DEPAKOTE ER ORAL TABLET EXTENDED RELEASE 24 HR 250 MG
divalproex sodium
valproic acid oral capsule
Antidepressants
Alpha-2 Receptor Antagonists (Tetracyclics)
Alpha-2 Receptor Antagonists (Tetracyclics)
mirtazapine oral
Antidepressants - Misc.
Antidepressants - Misc.
APLENZIN ORAL TABLET EXTENDED RELEASE 24 HR 174 MG, 348
MG
BUDEPRION SR
bupropion hcl oral
maprotiline hcl
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T2
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T2
NOTES
ST
T5
ST
T5
T5
PA
PA
T3
T4
T2
T4
T3
T2
T2
T2
T2
T4
ST
T2
T2
T4
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Modified Cyclics
Modified Cyclics
nefazodone hcl
trazodone hcl oral
VIIBRYD
Monoamine Oxidase Inhibitors (MAOIs)
Monoamine Oxidase Inhibitors (MAOIs)
EMSAM
MARPLAN
phenelzine sulfate oral
tranylcypromine sulfate
Selective Serotonin Reuptake Inhibitors (SSRIs)
Selective Serotonin Reuptake Inhibitors (SSRIs)
citalopram hydrobromide
escitalopram oxalate
fluoxetine hcl oral solution
fluvoxamine maleate
paroxetine hcl er
PAXIL ORAL SUSPENSION
sertraline hcl oral
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
CYMBALTA
venlafaxine hcl
venlafaxine hcl er oral capsule extended release 24 hour 150 MG, 75 MG
venlafaxine hcl er oral tablet extended release 24 hr 150 MG, 225 MG, 75 MG
Tricyclic Agents
Tricyclic Agents
amitriptyline hcl oral tablet 10 MG, 100 MG, 25 MG, 50 MG, 75 MG
amoxapine
clomipramine hcl oral
desipramine hcl oral
doxepin hcl oral capsule
doxepin hcl oral concentrate
imipramine hcl oral
nortriptyline hcl oral capsule
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T5
T4
T2
T3
NOTES
ST
PA
T1
T2
T2
T2
T2
T4
T1
T4
T2
T2
T2
ST
T1
T2
T2
T3
T2
T2
T3
T2
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
protriptyline hcl
Antidiabetics
Alpha-Glucosidase Inhibitors
Alpha-Glucosidase Inhibitors
acarbose
GLYSET
Antidiabetic Combinations
Dipeptidyl Peptidase-4 Inhibitor-Biguanide Combinations
JENTADUETO
Biguanides
Biguanides
metformin hcl oral tablet
Diabetic Other
Diabetic Other
GLUCAGEN HYPOKIT
PROGLYCEM
Dipeptidyl Peptidase-4 (DPP-4) Inhibitors
Dipeptidyl Peptidase-4 (DPP-4) Inhibitors
JANUVIA
ONGLYZA
TRADJENTA
Dopamine Receptor Agonists - Antidiabetic
Dopamine Receptor Agonists - Ergot Derivatives
CYCLOSET
Incretin Mimetic Agents (GLP-1 Receptor Agonists)
Incretin Mimetic Agents (GLP-1 Receptor Agonists)
BYDUREON
BYETTA 10 MCG PEN
BYETTA 5 MCG PEN
Insulin Sensitizing Agents
Thiazolidinediones
ACTOS
AVANDIA
Insulin
Human Insulin
HUMALOG MIX 50/50
Page 14
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NOTES
T3
T2
T4
ST
T3
T1
T3
T3
T4
T4
T3
ST
ST
T4
ST
T3
T3
T3
T4
T4
ST
T5
PA
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
HUMULIN R U-500 (CONCENTRATED)
LEVEMIR
NOVOLOG
NOVOLOG MIX 70/30
Meglitinide Analogues
Meglitinide Analogues
nateglinide
PRANDIN
Sulfonylureas
Sulfonylureas
chlorpropamide
glimepiride
glipizide oral
glipizide er
GLIPIZIDE XL
glyburide oral
glyburide micronized oral tablet 1.5 MG, 3 MG, 6 MG
tolazamide
tolbutamide
Antidiarrheals
Antiperistaltic Agents
Antiperistaltic Agents
diphenoxylate-atropine
loperamide hcl oral capsule
MOTOFEN
Antidotes
Antidotes - Chelating Agents
Antidotes - Chelating Agents
CHEMET
EXJADE
Opioid Antagonists
Opioid Antagonists
naltrexone hcl oral
Antiemetics
5-HT3 Receptor Antagonists
5-HT3 Receptor Antagonists
Page 15
TIER
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T3
T3
T3
NOTES
PA
T3
T4
ST
T2
T2
T1
T2
T2
T2
T1
T4
T4
ST
ST
T2
T2
T4
T4
T5
PA
T4
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
ANZEMET ORAL TABLET 50 MG
granisetron hcl oral tablet
GRANISOL
ondansetron oral tablet dispersible
ondansetron hcl oral
Antiemetics - Anticholinergic
Antiemetics - Anticholinergic
meclizine hcl oral tablet 25 MG
TIGAN INTRAMUSCULAR
Antiemetics - Miscellaneous
Antiemetics - Miscellaneous
CESAMET
dronabinol
Substance P/Neurokinin 1 (NK1) Receptor Antagonists
Substance P/Neurokinin 1 (NK1) Receptor Antagonists
EMEND ORAL CAPSULE 125 MG, 40 MG, 80 MG
Antifungals
Antifungals
Antifungals
flucytosine oral
griseofulvin microsize oral suspension
nystatin oral tablet
terbinafine hcl oral tablet
Imidazole-Related Antifungals
Imidazoles
ketoconazole oral
Triazoles
fluconazole oral
NOXAFIL ORAL SUSPENSION
VFEND ORAL SUSPENSION RECONSTITUTED
voriconazole oral tablet
Antihistamines
Antihistamines - Ethanolamines
Antihistamines - Ethanolamines
carbinoxamine maleate oral tablet
clemastine fumarate oral syrup
Page 16
TIER
T5
T2
T2
T2
T2
NOTES
PA
T2
T4
PA
T5
T5
PA
PA
T4
ST
T5
T3
T2
T2
T2
T2
T5
T5
T5
PA
PA
PA
T3
T2
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
clemastine fumarate oral tablet 2.68 MG
Antihistamines - Non-Sedating
Antihistamines - Non-Sedating
levocetirizine dihydrochloride oral
Antihistamines - Phenothiazines
Antihistamines - Phenothiazines
promethazine hcl oral tablet
promethazine hcl oral syrup
promethazine hcl re suppository 12.5 MG, 25 MG
Antihistamines - Piperidines
Antihistamines - Piperidines
cyproheptadine hcl oral
Antihyperlipidemics
Antihyperlipidemics - Misc.
Antihyperlipidemics - Misc.
LOVAZA
Bile Acid Sequestrants
Bile Acid Sequestrants
colestipol hcl oral packet
colestipol hcl oral tablet
PREVALITE ORAL POWDER
WELCHOL ORAL TABLET
Fibric Acid Derivatives
Fibric Acid Derivatives
fenofibrate oral tablet 160 MG, 54 MG
fenofibrate micronized oral capsule 134 MG, 200 MG, 67 MG
gemfibrozil oral
HMG COA Reductase Inhibitors
HMG COA Reductase Inhibitors
atorvastatin calcium
CRESTOR ORAL TABLET 40 MG
fluvastatin sodium
LIVALO
lovastatin
pravastatin sodium oral tablet 20 MG, 40 MG, 80 MG
pravastatin sodium oral tablet 10 MG
Page 17
TIER
NOTES
T2
T2
T1
T2
T2
T3
T4
T2
T2
T2
T4
ST
T2
T2
T2
T2
T4
T4
T4
T2
T1
T2
PA
PA
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
simvastatin oral
Intestinal Cholesterol Absorption Inhibitors
Intestinal Cholesterol Absorption Inhibitors
ZETIA
Nicotinic Acid Derivatives
Nicotinic Acid Derivatives
NIACOR
Antihypertensives
ACE Inhibitors
ACE Inhibitors
benazepril hcl oral
captopril oral
enalapril maleate oral tablet
fosinopril sodium
lisinopril oral
moexipril hcl
perindopril erbumine
quinapril hcl
ramipril oral capsule
trandolapril
Agents For Pheochromocytoma
Agents For Pheochromocytoma
DIBENZYLINE
Angiotensin II Receptor Antagonists
Angiotensin II Receptor Antagonists
ATACAND
BENICAR
DIOVAN
EDARBI
eprosartan mesylate oral tablet 600 MG
irbesartan
losartan potassium
MICARDIS
Antiadrenergic Antihypertensives
Antiadrenergics - Centrally Acting
clonidine hcl oral
Page 18
TIER
NOTES
T1
T4
T2
T2
T1
T1
T2
T1
T3
T3
T2
T2
T3
T4
T4
T4
T4
T4
T3
T3
T2
T4
ST
ST
ST
ST
ST
T1
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
guanfacine hcl oral
methyldopa oral
Antiadrenergics - Peripherally Acting
doxazosin mesylate
prazosin hcl oral capsule 1 MG, 2 MG
terazosin hcl oral
Direct Renin Inhibitors
Direct Renin Inhibitors
TEKTURNA
Selective Aldosterone Receptor Antagonists (SARAs)
Selective Aldosterone Receptor Antagonists (SARAs)
eplerenone
Vasodilators
Vasodilators
hydralazine hcl oral
minoxidil oral
Anti-Infective Agents - Misc.
Anti-Infective Agents - Misc.
Anti-Infective Agents - Misc.
metronidazole oral tablet
PENTAM
trimethoprim oral
vancomycin hcl oral
XIFAXAN ORAL TABLET 200 MG
Anti-Infective Misc. - Combinations
Anti-Infective Misc. - Combinations
sulfamethoxazole-trimethoprim oral tablet 400-80 MG
Antiprotozoal Agents
Antiprotozoal Agents
ALINIA
MEPRON
Carbapenems
Carbapenems
meropenem intravenous solution reconstituted 1 GM
Ketolides
Ketolides
Page 19
TIER
NOTES
T2
T2
T2
T2
T2
T4
ST
T4
T2
T2
T1
T5
T2
T5
T5
PA
PA
PA
T1
T4
T4
PA
T5
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
KETEK ORAL TABLET 300 MG
Leprostatics
Leprostatics
dapsone oral
Lincosamides
Lincosamides
clindamycin hcl oral capsule 150 MG, 300 MG
Oxazolidinones
Oxazolidinones
ZYVOX ORAL
Antimalarials
Antimalarial Combinations
Antimalarial Combinations
atovaquone-proguanil hcl oral tablet 250-100 MG
COARTEM
MALARONE ORAL TABLET 62.5-25 MG
Antimalarials
Antimalarials
chloroquine phosphate oral tablet 500 MG
DARAPRIM
hydroxychloroquine sulfate oral
mefloquine hcl
primaquine phosphate oral
QUALAQUIN
Antimyasthenic/Cholinergic Agents
Antimyasthenic/Cholinergic Agents
Antimyasthenic/Cholinergic Agents
MESTINON ORAL TABLET
MESTINON ORAL TABLET EXTENDEDRELEASE
MYTELASE
pyridostigmine bromide oral tablet
REGONOL
Antimycobacterial Agents
Anti TB Combinations
Anti TB Combinations
RIFATER
Page 20
TIER
T4
NOTES
PA
T3
T2
T5
PA
T3
T4
T3
T2
T3
T2
T2
T3
T4
T4
T4
T3
T2
T4
T4
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Antimycobacterial Agents
Antimycobacterial Agents
CAPASTAT SULFATE
ethambutol hcl oral
isoniazid oral
MYCOBUTIN
PASER
PRIFTIN
rifampin oral
SEROMYCIN
TRECATOR
Antineoplastics And Adjunctive Therapies
Alkylating Agents
Alkylating Agents
HEXALEN
Nitrogen Mustards
cyclophosphamide oral
LEUKERAN
melphalan hcl
Antimetabolites
Antimetabolites
fludarabine phosphate intravenous solution 25 MG/ML
fluorouracil intravenous solution 5 GM/100ML
mercaptopurine oral
methotrexate sodium injection solution reconstituted
methotrexate sodium (pf) injection solution 200 MG/8ML
TABLOID
TREXALL
Antineoplastic - Antibodies
Antineoplastic - Monoclonal Antibodies
RITUXAN
Antineoplastic - Hormonal And Related Agents
Androgen Biosynthesis Inhibitors
ZYTIGA
Antiadrenals
LYSODREN
Page 21
TIER
NOTES
T4
T2
T2
T4
T4
T4
T2
T4
T4
T5
PA
T3
T3
T5
T5
T3
T2
T2
T2
T4
T4
PA
T5
PA
T5
PA
T3
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Antiandrogens
bicalutamide
flutamide
NILANDRON
Antiestrogens
FARESTON
tamoxifen citrate oral tablet
Aromatase Inhibitors
anastrozole oral
exemestane
letrozole oral
Estrogens-Antineoplastic
EMCYT
LHRH Analogs
leuprolide acetate injection kit 1 MG/0.2ML
Progestins-Antineoplastic
megestrol acetate oral tablet
Antineoplastic Enzyme Inhibitors
Antineoplastic - Histone Deacetylase Inhibitors
ZOLINZA
Antineoplastic - mTOR Kinase Inhibitors
AFINITOR
Antineoplastic - Multikinase Inhibitors
NEXAVAR
SUTENT
Antineoplastic - Tyrosine Kinase Inhibitors
CAPRELSA
GLEEVEC
SPRYCEL
TARCEVA
TASIGNA
TYKERB
VOTRIENT
XALKORI
Janus Associated Kinase (JAK) Inhibitors
JAKAFI
Page 22
TIER
NOTES
T2
T2
T3
T5
T2
T2
T4
T4
ST
ST
T4
PA
T5
PA
T2
T5
PA
T5
PA
T5
T5
PA
PA
T5
T5
T5
T5
T5
T5
T5
T5
PA
PA
PA
PA
PA
PA
PA
PA
T5
PA
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Antineoplastics Misc.
Antineoplastics Misc.
ACTIMMUNE
hydroxyurea oral capsule 500 MG
INTRON-A INJECTION SOLUTION 10000000 UNIT/ML
MATULANE
Retinoids
tretinoin oral
Selective Retinoid X Receptor Agonists
TARGRETIN
Chemotherapy Adjuncts
Chemotherapy Adjuncts - Keratinocyte Growth Factors
KEPIVANCE
Chemotherapy Rescue/Antidote Agents
Folic Acid Antagonists Rescue Agents
leucovorin calcium oral tablet 25 MG, 5 MG
leucovorin calcium oral tablet 10 MG, 15 MG
Antiparkinson Agents
Antiparkinson Adjuvants
Decarboxylase Inhibitors
LODOSYN
Antiparkinson Anticholinergics
Antiparkinson Anticholinergics
benztropine mesylate oral
trihexyphenidyl hcl
Antiparkinson COMT Inhibitors
Central/Peripheral COMT Inhibitors
TASMAR
Peripheral COMT Inhibitors
COMTAN
Antiparkinson Dopaminergics
Antiparkinson Dopaminergics
amantadine hcl oral
bromocriptine mesylate oral capsule
bromocriptine mesylate oral tablet 2.5 MG
Page 23
TIER
NOTES
T5
T2
T5
T5
PA
T5
PA
T5
PA
PA
T5
T2
T3
T4
T2
T2
T5
T4
T2
T2
T2
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Levodopa Combinations
carbidopa-levodopa oral tablet
carbidopa-levodopa er
Nonergoline Dopamine Receptor Agonists
MIRAPEX ER ORAL TABLET EXTENDED RELEASE 24 HR 3 MG
pramipexole dihydrochloride oral tablet 0.125 MG, 0.25 MG, 0.5 MG, 1 MG,
1.5 MG
ropinirole hcl
Antiparkinson Monoamine Oxidase Inhibitors
Antiparkinson Monoamine Oxidase Inhibitors
AZILECT
selegiline hcl oral capsule
selegiline hcl oral tablet
Antipsychotics/Antimanic Agents
Antimanic Agents
Antimanic Agents
lithium carbonate oral capsule 150 MG, 300 MG
lithium carbonate oral capsule 600 MG
lithium carbonate oral tablet
lithium carbonate er
Antipsychotics - Misc.
Antipsychotics - Misc.
LATUDA ORAL TABLET 20 MG, 40 MG, 80 MG
ziprasidone hcl
Benzisoxazoles
Benzisoxazoles
FANAPT
FANAPT TITRATION PACK
INVEGA SUSTENNA INTRAMUSCULAR SUSPENSION 117 MG/0.75ML,
234 MG/1.5ML, 39 MG/0.25ML, 78 MG/0.5ML
RISPERDAL CONSTA
risperidone oral solution
risperidone oral tablet dispersible 0.25 MG
risperidone oral tablet
RISPERIDONE M-TAB
Butyrophenones
Page 24
TIER
NOTES
T2
T2
T5
T2
PA
T2
T4
T2
T2
T2
T3
T3
T2
T4
T4
PA
T4
T4
T4
PA
PA
PA
T4
T2
T2
T2
T2
PA
ST
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Butyrophenones
haloperidol oral
haloperidol decanoate intramuscular
haloperidol lactate
Dibenzapines
Dibenzodiazepines
clozapine oral tablet
FAZACLO
Dibenzo-Oxepino Pyrroles
SAPHRIS
Dibenzothiazepines
quetiapine fumarate
SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 HR 150 MG,
50 MG
Dibenzoxazepines
loxapine succinate oral
Thienbenzodiazepines
olanzapine oral
Phenothiazines
Phenothiazines
chlorpromazine hcl oral
fluphenazine hcl oral tablet
fluphenazine hcl oral concentrate
fluphenazine hcl oral elixir
perphenazine oral
prochlorperazine
prochlorperazine maleate oral
thioridazine hcl oral
trifluoperazine hcl oral
Quinolinone Derivatives
Quinolinone Derivatives
ABILIFY ORAL SOLUTION
ABILIFY ORAL TABLET 10 MG, 15 MG, 2 MG, 5 MG
ABILIFY ORAL TABLET 20 MG, 30 MG
ABILIFY DISCMELT
Thioxanthenes
Page 25
TIER
NOTES
T2
T2
T2
T2
T4
PA
T4
PA
T2
T4
PA
T2
T3
T2
T2
T3
T3
T2
T2
T2
T3
T2
T4
T4
T5
T5
PA
PA
PA
PA
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Thioxanthenes
thiothixene oral capsule 1 MG, 10 MG, 2 MG, 5 MG
Antivirals
Antiretrovirals
Antiretroviral Combinations
EPZICOM
KALETRA
lamivudine-zidovudine
TRIZIVIR
TRUVADA
Antiretrovirals - CCR5 Antagonists (Entry Inhibitor)
SELZENTRY
Antiretrovirals - Fusion Inhibitors
FUZEON SUBCUTANEOUS SOLUTION RECONSTITUTED
Antiretrovirals - Integrase Inhibitors
ISENTRESS ORAL TABLET
Antiretrovirals - Protease Inhibitors
APTIVUS
CRIXIVAN ORAL CAPSULE 200 MG, 400 MG
INVIRASE
LEXIVA
NORVIR
PREZISTA ORAL TABLET 150 MG, 400 MG, 600 MG, 75 MG
REYATAZ ORAL CAPSULE 150 MG, 200 MG, 300 MG
VIRACEPT ORAL TABLET
Antiretrovirals - RTI-Non-Nucleoside Analogues
EDURANT
INTELENCE ORAL TABLET 100 MG, 200 MG
nevirapine oral tablet
RESCRIPTOR
SUSTIVA
Antiretrovirals - RTI-Nucleoside Analogues-Purines
didanosine oral capsule delayed release
VIDEX ORAL SOLUTION RECONSTITUTED 4 GM
ZIAGEN ORAL SOLUTION
Page 26
TIER
NOTES
T2
T5
T5
T3
T5
T5
PA
PA
PA
PA
PA
T5
PA
T5
PA
T5
PA
T5
T5
T5
T5
T5
T5
T5
T5
PA
PA
PA
PA
PA
PA
PA
PA
T5
T5
T3
T5
T5
PA
PA
PA
PA
PA
T3
T5
T5
PA
PA
PA
Antiretrovirals - RTI-Nucleoside Analogues-Pyrimidines
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
EMTRIVA
EPIVIR ORAL SOLUTION
EPIVIR HBV
lamivudine oral tablet 150 MG, 300 MG
Antiretrovirals - RTI-Nucleoside Analogues-Thymidines
RETROVIR INTRAVENOUS
stavudine oral capsule
zidovudine oral capsule
zidovudine oral syrup 50 MG/5ML
zidovudine oral tablet
Antiretrovirals - RTI-Nucleotide Analogues
VIREAD
CMV Agents
CMV Agents
VALCYTE
Hepatitis Agents
Hepatitis B Agents
BARACLUDE
HEPSERA
TYZEKA
Hepatitis C Agents
INCIVEK
INFERGEN
PEGASYS
PEGASYS PROCLICK
PEG-INTRON SUBCUTANEOUS KIT 50 MCG/0.5ML
PEG-INTRON REDIPEN
PEG-INTRON REDIPEN PAK 4
ribavirin oral capsule
ribavirin oral tablet 200 MG
VICTRELIS
Herpes Agents
Herpes Agents - Purine Analogues
acyclovir oral
valacyclovir hcl oral
Herpes Agents - Thymidine Analogues
Page 27
TIER
NOTES
T5
T5
T4
T3
PA
PA
PA
PA
T5
T3
T3
T3
T3
PA
PA
PA
PA
PA
T5
PA
T5
T5
T5
T5
PA
PA
PA
T5
T5
T5
T5
T5
T5
T5
T3
T3
T5
PA
PA
PA
PA
PA
PA
PA
PA
PA
PA
T2
T3
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
famciclovir
Influenza Agents
Influenza Agents
rimantadine hcl
Neuraminidase Inhibitors
RELENZA DISKHALER
TAMIFLU ORAL CAPSULE 75 MG
Assorted Classes
Chelating Agents
Chelating Agents
DEPEN TITRATABS
SYPRINE
Immunomodulators
Antileprotics
THALOMID
Immunomodulators For Myelodysplastic Syndromes
REVLIMID ORAL CAPSULE 10 MG, 15 MG, 25 MG, 5 MG
Immunosuppressive Agents
Cyclosporine Analogs
cyclosporine oral capsule 25 MG
cyclosporine modified oral capsule 100 MG
cyclosporine modified oral solution
cyclosporine modified oral capsule 50 MG
GENGRAF
Immune Globulin Immunosuppressants
THYMOGLOBULIN
Inosine Monophosphate Dehydrogenase Inhibitors
CELLCEPT
mycophenolate mofetil oral capsule
MYFORTIC ORAL TABLET DELAYED RELEASE 180 MG
MYFORTIC ORAL TABLET DELAYED RELEASE 360 MG
Macrolide Immunosuppressants
PROGRAF ORAL
RAPAMUNE
tacrolimus oral capsule
ZORTRESS
Page 28
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NOTES
T3
T2
PA
T5
T4
PA
T4
T4
T5
PA
T5
PA
T2
T2
T2
T3
T2
T5
PA
T4
T3
T4
T5
T4
T3
T3
T3
PA
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Purine Analogs
AZASAN
azathioprine oral tablet 50 MG
Selective T-Cell Costimulation Blockers
NULOJIX
Irrigation Solutions
Irrigation Solutions
PHYSIOLYTE
Potassium Removing Resins
Potassium Removing Resins
KAYEXALATE
Beta Blockers
Alpha-Beta Blockers
Alpha-Beta Blockers
carvedilol
COREG CR ORAL CAPSULE EXTENDED RELEASE 24 HOUR 10 MG, 20
MG
labetalol hcl oral
Beta Blockers Cardio-Selective
Beta Blockers Cardio-Selective
acebutolol hcl oral
atenolol oral
betaxolol hcl oral tablet 20 MG
bisoprolol fumarate
BYSTOLIC
metoprolol tartrate oral
Beta Blockers Non-Selective
Beta Blockers Non-Selective
INNOPRAN XL ORAL CAPSULE EXTENDED RELEASE 24 HOUR 120
MG
LEVATOL
nadolol oral
pindolol oral tablet 5 MG
propranolol hcl oral tablet
propranolol hcl oral solution
sotalol hcl oral tablet 240 MG
Page 29
TIER
NOTES
T3
T2
T5
PA
T2
T4
T1
T4
ST
T2
T2
T1
T2
T2
T4
T1
ST
T4
T4
T3
T3
T1
T3
T2
ST
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
timolol maleate oral
Biologicals Misc
Biologicals Misc
Biologicals Misc
ADAGEN
Calcium Channel Blockers
Calcium Channel Blockers
Calcium Channel Blockers
amlodipine besylate oral tablet 10 MG, 5 MG
amlodipine besylate oral tablet 2.5 MG
CARDIZEM CD ORAL CAPSULE EXTENDED RELEASE 24 HOUR 120
MG
CARTIA XT ORAL CAPSULE EXTENDED RELEASE 24 HOUR 180 MG,
240 MG, 300 MG
diltiazem hcl oral
felodipine er oral tablet extended release 24 hr 2.5 MG, 5 MG
isradipine
nicardipine hcl oral
nifedipine oral capsule 10 MG
nifedipine oral capsule 20 MG
nimodipine oral capsule
nisoldipine er oral tablet extended release 24 hr 40 MG, 8.5 MG
verapamil hcl oral
verapamil hcl er oral capsule extended release 24 hour 100 MG, 120 MG, 180
MG, 200 MG, 240 MG, 300 MG
verapamil hcl er oral tablet extendedrelease 120 MG
verapamil hcl er (co)
Cardiotonics
Cardiac Glycosides
Cardiac Glycosides
digoxin oral tablet
digoxin oral solution
Cardiovascular Agents - Misc.
Prostaglandin Vasodilators
Prostaglandin Vasodilators
REMODULIN INJECTION SOLUTION 1 MG/ML
Page 30
TIER
NOTES
T2
T5
PA
T1
T2
T2
T2
T2
T3
T3
T3
T2
T3
T4
T3
T2
T3
T3
T3
T1
T3
T5
PA
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
VENTAVIS INHALATION SOLUTION 10 MCG/ML
Pulmonary Hypertension - Endothelin Receptor Antagonists
Pulmonary Hypertension - Endothelin Receptor Antagonists
LETAIRIS
TRACLEER
Pulmonary Hypertension - Phosphodiesterase Inhibitors
Pulmonary Hypertension - Phosphodiesterase Inhibitors
ADCIRCA
Cephalosporins
Cephalosporins – 1st Generation
Cephalosporins – 1st Generation
cefadroxil oral
cefazolin sodium injection solution reconstituted 300 GM
cephalexin oral capsule 250 MG, 500 MG
Cephalosporins – 2nd Generation
Cephalosporins – 2nd Generation
cefaclor oral capsule
cefuroxime axetil oral tablet
Cephalosporins – 3rd Generation
Cephalosporins – 3rd Generation
CEDAX ORAL CAPSULE
cefdinir oral suspension reconstituted
cefpodoxime proxetil oral suspension reconstituted 50 MG/5ML
cefpodoxime proxetil oral tablet
ceftriaxone sodium injection solution reconstituted 250 MG
SUPRAX ORAL SUSPENSION RECONSTITUTED 100 MG/5ML, 200
MG/5ML
SUPRAX ORAL TABLET
Contraceptives
Emergency Contraceptives
Emergency Contraceptives
ELLA
Progestin Contraceptives - Oral
Progestin Contraceptives - Oral
ERRIN
Corticosteroids
Page 31
TIER
NOTES
T5
PA
T5
T5
PA
PA
T5
PA
T2
T2
T1
T2
T2
T4
T3
T3
T3
T2
T4
T4
T4
T2
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Glucocorticosteroids
Glucocorticosteroids
cortisone acetate oral
dexamethasone oral solution
dexamethasone oral tablet
hydrocortisone oral
methylprednisolone oral tablet 4 MG, 8 MG
methylprednisolone (pak)
prednisolone oral solution
prednisone oral tablet 2.5 MG, 20 MG, 5 MG
prednisone oral tablet 1 MG, 50 MG
Mineralocorticoids
Mineralocorticoids
fludrocortisone acetate oral
Cough/Cold/Allergy
Mucolytics
Mucolytics
acetylcysteine inhalation solution 10 %
Dermatologicals
Acne Products
Acne Antibiotics
clindamycin phosphate external gel
clindamycin phosphate external lotion
clindamycin phosphate external solution
ery
erythromycin external gel
erythromycin external solution
Acne Combinations
ACANYA
BENZAMYCINPAK
EPIDUO
ZIANA
Acne Products
adapalene external cream
AMNESTEEM
CLARAVIS
Page 32
TIER
NOTES
T2
T2
T2
T2
T2
T2
T2
T1
T2
T2
T2
T2
T2
T2
T2
T2
T2
T4
T5
T4
T4
T4
T5
T5
PA
PA
PA
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
tretinoin external cream 0.025 %, 0.1 %
tretinoin external gel 0.01 %
Agents For External Genital And Perianal Warts
Agents For External Genital And Perianal Warts
VEREGEN
Antibiotics - Topical
Antibiotic Steroid Combinations - Topical
CORTISPORIN EXTERNAL
Antibiotics - Topical
ALTABAX
gentamicin sulfate external
Antifungals - Topical
Antifungals - Topical Combinations
clotrimazole-betamethasone
nystatin-triamcinolone
Antifungals - Topical
ciclopirox external gel
ciclopirox external shampoo
ciclopirox olamine external suspension
MENTAX
NAFTIN EXTERNAL GEL 1 %
nystatin external cream
nystatin external ointment
nystatin external powder 100000 UNIT/GM
NYSTOP
Page 33
TIER
NOTES
T2
T2
T4
T4
T4
T2
T2
T1
T3
T3
T3
T4
T4
T2
T2
T2
T2
Imidazole-Related Antifungals - Topical
econazole nitrate external
ERTACZO
EXELDERM
ketoconazole external cream
ketoconazole external shampoo 2 %
OXISTAT EXTERNAL CREAM
T2
T5
T4
T2
T2
T4
Anti-Inflammatory Agents - Topical
Anti-Inflammatory Agents - Topical
VOLTAREN TRANSDERMAL
T3
ST
ST
PA
ST
ST
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Antineoplastic Or Premalignant Lesion Agents - Topical
Antineoplastic Or Premalignant Lesions - Topical Misc.
PICATO
Antineoplastic Or Premalignant Lesions - Topical NSAIDs
SOLARAZE
Antineoplastic Retinoids - Topical
PANRETIN
Topical Selective Retinoid X Receptor Agonists
TARGRETIN
Page 34
TIER
NOTES
T5
PA
T5
PA
T5
PA
T5
PA
Antipruritics - Topical
Antipruritics - Topical
ZONALON
T4
Antipsoriatics
Antipsoriatics - Systemic
8-MOP
SORIATANE ORAL CAPSULE 17.5 MG
T5
T5
PA
T4
T4
T5
PA
Antipsoriatics
calcipotriene external solution
TAZORAC
VECTICAL
Antiseborrheic Products
Antiseborrheic Products
selenium sulfide external lotion 2.5 %
Antivirals - Topical
Antivirals - Topical
DENAVIR
ZOVIRAX EXTERNAL
Burn Products
Burn Products
SILVADENE
silver sulfadiazine external
SSD
SULFAMYLON EXTERNAL CREAM
Corticosteroids - Topical
Corticosteroids - Topical
alclometasone dipropionate
T2
T4
T4
T2
T2
T2
T4
T3
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
amcinonide external cream
betamethasone dipropionate aug external lotion
clobetasol propionate external gel
clobetasol propionate external ointment
clobetasol propionate external solution
CLODERM PUMP
CUTIVATE EXTERNAL LOTION
DERMA-SMOOTHE/FS SCALP
desoximetasone external cream 0.25 %
desoximetasone external gel
desoximetasone external ointment 0.25 %
fluocinolone acetonide external cream 0.01 %
fluocinonide external gel
fluocinonide external ointment
fluocinonide external solution
fluticasone propionate external cream
fluticasone propionate external ointment
halobetasol propionate
HALOG EXTERNAL OINTMENT
hydrocortisone external cream 2.5 %
hydrocortisone external lotion 2.5 %
hydrocortisone external ointment 2.5 %
hydrocortisone valerate
mometasone furoate external cream
mometasone furoate external ointment
OLUX-E
prednicarbate
triamcinolone acetonide external cream 0.025 %, 0.5 %
triamcinolone acetonide external lotion
triamcinolone acetonide external ointment 0.025 %, 0.1 %, 0.5 %
Topical Steroid Combinations
TACLONEX EXTERNAL OINTMENT
Emollients
Emollients
ammonium lactate external cream 12 %
Enzymes - Topical
Page 35
TIER
T2
T2
T2
T2
T2
T2
T3
T3
T2
T2
T2
T1
T2
T2
T2
T2
T2
T2
T4
T2
T2
T2
T2
T2
T2
T5
T3
T2
T2
T2
T5
NOTES
PA
PA
T2
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Enzymes - Topical
SANTYL
Immunomodulating Agents - Topical
Immunomodulators Imidazoquinolinamines - Topical
ALDARA
Immunosuppressive Agents - Topical
Macrolide Immunosuppressants - Topical
ELIDEL
PROTOPIC
Keratolytic/Antimitotic Agents
Keratolytic/Antimitotic Agents
CONDYLOX EXTERNAL GEL
podofilox external solution
Local Anesthetics - Topical
Local Anesthetics - Topical
lidocaine hcl external gel 2 %
Topical Anesthetic Combinations
lidocaine-prilocaine external kit
SYNERA
Rosacea Agents
Rosacea Agents
FINACEA
Scabicides & Pediculicides
Scabicides & Pediculicides
EURAX
lindane external
malathion external
permethrin external cream
ULESFIA
Wound Care Products
Wound Care - Growth Factor Agents
REGRANEX
Page 36
TIER
T4
NOTES
PA
T4
T4
T5
PA
T4
T3
T2
T2
T4
PA
T4
T4
T2
T2
T2
T4
ST
T4
PA
Digestive Aids
Digestive Enzymes
Digestive Enzymes
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
CREON ORAL CAPSULE DELAYED RELEASE PARTICLES 12000 UNIT,
24000 UNIT, 6000 UNIT
Diuretics
Carbonic Anhydrase Inhibitors
Carbonic Anhydrase Inhibitors
acetazolamide oral
acetazolamide sodium
methazolamide oral
Loop Diuretics
Loop Diuretics
bumetanide oral
EDECRIN
furosemide oral tablet
furosemide oral solution 8 MG/ML
torsemide oral
Potassium Sparing Diuretics
Potassium Sparing Diuretics
amiloride hcl oral
DYRENIUM
spironolactone oral
Thiazides and Thiazide-Like Diuretics
Thiazides and Thiazide-Like Diuretics
chlorothiazide oral tablet
chlorthalidone oral tablet 25 MG, 50 MG
DIURIL
hydrochlorothiazide oral tablet 25 MG, 50 MG
hydrochlorothiazide oral capsule
indapamide oral
methyclothiazide oral
metolazone
Endocrine And Metabolic Agents - Misc.
Bone Density Regulators
Bisphosphonates
ACTONEL ORAL TABLET 150 MG, 30 MG, 5 MG
alendronate sodium oral tablet
etidronate disodium
Page 37
TIER
NOTES
T5
T3
T3
T2
T2
T4
T1
T3
T2
T3
T4
T2
ST
T2
T2
T3
T1
T2
T2
T3
T2
T4
T2
T3
ST
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
ibandronate sodium oral
pamidronate disodium intravenous solution 6 MG/ML
RECLAST
Calcitonins
MIACALCIN
Parathyroid Hormone And Derivatives
FORTEO
RANK Ligand (RANKL) Inhibitors
PROLIA
Growth Hormone Receptor Antagonists
Growth Hormone Receptor Antagonists
SOMAVERT SUBCUTANEOUS SOLUTION RECONSTITUTED 10 MG
Growth Hormones
Growth Hormones
SEROSTIM SUBCUTANEOUS SOLUTION RECONSTITUTED 4 MG, 6
MG
Hormone Receptor Modulators
Selective Estrogen Receptor Modulators (SERMs)
EVISTA
Insulin-Like Growth Factors (Somatomedins)
Insulin-Like Growth Factors (Somatomedins)
INCRELEX
LHRH/GNRH Agonist Analog Pituitary Suppressants
LHRH/GNRH Agonist Analog Pituitary Suppressants
SYNAREL
Metabolic Modifiers
Calcimimetic Agents
SENSIPAR
GAA Deficiency Treatment - Agents
LUMIZYME
Hereditary Tyrosinemia Type 1 (HT-1) Treatment - Agents
ORFADIN
Hyperparathyroid Treatment - Vitamin D Analogs
calcitriol oral
HECTOROL ORAL
ZEMPLAR ORAL
Page 38
TIER
NOTES
T3
T5
T5
PA
PA
T4
PA
T5
PA
T5
PA
T5
PA
T5
PA
T3
T5
PA
T5
T5
PA
T5
PA
T5
PA
T2
T4
T4
PA
PA
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Mucopolysaccharidosis VI (MPS VI) - Agents
NAGLAZYME
Phenylketonuria Treatment - Agents
KUVAN
Urea Cycle Disorder - Agents
BUPHENYL ORAL TABLET
Posterior Pituitary Hormones
Vasopressin
desmopressin acetate oral
Prolactin Inhibitors
Dopamine Receptor Agonists
cabergoline
Somatostatic Agents
Somatostatic Agents
octreotide acetate injection solution 1000 MCG/5ML, 1000 MCG/ML
SANDOSTATIN LAR DEPOT
Vasopressin Receptor Antagonists
Selective Vasopressin V2-Receptor Antagonists
SAMSCA
Estrogens
Estrogens
Estrogens
CENESTIN
ENJUVIA
estradiol transdermal patch weekly 0.05 MG/24HR, 0.06 MG/24HR, 0.075
MG/24HR, 0.1 MG/24HR
estradiol oral
estropipate oral
MENEST
PREMARIN ORAL TABLET 0.3 MG, 0.45 MG, 0.9 MG, 1.25 MG
PREMARIN ORAL TABLET 0.625 MG
Fluoroquinolones
Fluoroquinolones
Fluoroquinolones
AVELOX INTRAVENOUS
ciprofloxacin hcl oral tablet 250 MG, 500 MG, 750 MG
Page 39
TIER
NOTES
T5
PA
T5
PA
T5
PA
T2
T2
T5
T5
PA
PA
T5
PA
T3
T3
T2
T2
T3
T4
T3
T3
PA
PA
PA
T3
T2
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
FACTIVE
levofloxacin oral solution
levofloxacin oral tablet 250 MG, 500 MG
NOROXIN
ofloxacin
Gastrointestinal Agents - Misc.
Gallstone Solubilizing Agents
Gallstone Solubilizing Agents
ursodiol oral capsule
Gastrointestinal Antiallergy Agents
Gastrointestinal Antiallergy Agents
cromolyn sodium oral
Gastrointestinal Chloride Channel Activators
Gastrointestinal Chloride Channel Activators
AMITIZA ORAL CAPSULE 24 MCG
AMITIZA ORAL CAPSULE 8 MCG
Gastrointestinal Stimulants
Gastrointestinal Stimulants
metoclopramide hcl oral tablet
Inflammatory Bowel Agents
Inflammatory Bowel Agents
balsalazide disodium oral capsule
DIPENTUM
LIALDA
sulfasalazine oral tablet
Tumor Necrosis Factor Alpha Blockers
REMICADE
Irritable Bowel Syndrome (IBS) Agents
IBS Agent - Selective 5-Ht3 Receptor Antagonists
LOTRONEX
Phosphate Binder Agents
Phosphate Binder Agents
calcium acetate oral capsule
FOSRENOL ORAL TABLET CHEWABLE 1000 MG, 500 MG
RENAGEL ORAL TABLET 800 MG
RENVELA ORAL TABLET
Page 40
TIER
NOTES
T4
T2
T2
T4
T2
T2
T2
T3
T4
ST
PA; ST
T2
T2
T4
T4
T2
PA
T5
PA
T5
PA
T2
T3
T4
T3
ST
ST
ST
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Genitourinary Agents - Miscellaneous
Cystinosis Agents
Cystinosis Agents
CYSTAGON
Interstitial Cystitis Agents
Interstitial Cystitis Agents
ELMIRON
Prostatic Hypertrophy Agents
5-Alpha Reductase Inhibitors
AVODART
finasteride oral tablet 5 MG
Alpha 1-Adrenoceptor Antagonists
alfuzosin hcl er
RAPAFLO
tamsulosin hcl
Gout Agents
Gout Agent Combinations
Gout Agent Combinations
colchicine-probenecid
Gout Agents
Gout Agents
allopurinol oral
COLCRYS
ULORIC
Uricosurics
Uricosurics
probenecid oral
Hematological Agents - Misc.
Hematorheologic Agents
Hematorheologic Agents
pentoxifylline er
Platelet Aggregation Inhibitors
Cyclopentyltriazolopyrimidine (CPTP) Derivatives
BRILINTA
Phosphodiesterase III Inhibitors
cilostazol
Page 41
TIER
T4
NOTES
PA
T4
T3
T2
T3
T4
T2
ST
T2
T1
T3
T4
ST
T2
T2
T4
PA
T2
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Platelet Aggregation Inhibitor Combinations
AGGRENOX
Platelet Aggregation Inhibitors
dipyridamole oral
Quinazoline Agents
anagrelide hcl oral capsule 1 MG
anagrelide hcl oral capsule 0.5 MG
Thienopyridine Derivatives
clopidogrel bisulfate oral tablet 75 MG
EFFIENT
ticlopidine hcl
Hematopoietic Agents
Agents For Gaucher Disease
Agents For Gaucher Disease
ZAVESCA
Agents For Sickle Cell Anemia
Cytotoxic Agents
DROXIA
Hematopoietic Growth Factors
Erythropoiesis-Stimulating Agents (ESAs)
ARANESP (ALBUMIN FREE) INJECTION SOLUTION 25 MCG/ML, 300
MCG/ML, 40 MCG/ML
PROCRIT INJECTION SOLUTION 2000 UNIT/ML, 20000 UNIT/ML, 3000
UNIT/ML, 4000 UNIT/ML, 40000 UNIT/ML
Granulocyte Colony-Stimulating Factors (G-CSF)
NEULASTA
NEUPOGEN INJECTION SOLUTION 480 MCG/1.6ML
Granulocyte/Macrophage Colony-Stimulating Factor (GM-CSF)
LEUKINE INJECTION
Thrombopoietin (TPO) Receptor Agonists
PROMACTA
Hemostatics
Hemostatics - Systemic
Hemostatics - Systemic
CYKLOKAPRON
Hypnotics
Page 42
TIER
T4
NOTES
PA
T2
T2
T3
T2
T4
T2
PA
T5
PA
T4
T5
PA
T5
PA
T5
T5
PA
PA
T5
PA
T5
PA
T4
PA
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Hypnotics - Tricyclic Agents
Hypnotics - Tricyclic Agents
SILENOR ORAL TABLET 6 MG
Non-Barbiturate Hypnotics
Benzodiazepine Hypnotics
flurazepam hcl oral capsule 30 MG
Non-Benzodiazepine - GABA-Receptor Modulators
LUNESTA
zaleplon
zolpidem tartrate oral tablet
Selective Melatonin Receptor Agonists
Selective Melatonin Receptor Agonists
ROZEREM
Laxatives
Laxative Combinations
Bowel Evacuant Combinations
MOVIPREP
SUPREP BOWEL PREP
Laxatives - Miscellaneous
Laxatives - Miscellaneous
lactulose oral solution 20 GM/30ML
polyethylene glycol 3350 oral
Saline Laxatives
Saline Laxative Mixtures
OSMOPREP
Macrolides
Azithromycin
Azithromycin
azithromycin oral suspension reconstituted 100 MG/5ML, 200 MG/5ML
azithromycin oral tablet 500 MG, 600 MG
Clarithromycin
Clarithromycin
clarithromycin oral
Erythromycins
Erythromycins
E.E.S. 400
Page 43
TIER
NOTES
T4
T2
T4
T2
T2
PA
T4
T4
T4
T2
T2
T4
T2
T2
T2
T4
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
erythromycin base oral tablet 250 MG
Fidaxomicin
Fidaxomicin
DIFICID
Migraine Products
Migraine Combinations
Ergot Combinations
MIGERGOT
Migraine Products
Migraine Products
dihydroergotamine mesylate injection
Serotonin Agonists
Selective Serotonin Agonists 5-HT(1)
AXERT
FROVA
MAXALT
naratriptan hcl
RELPAX
sumatriptan succinate oral
ZOMIG ORAL
ZOMIG ZMT
Minerals & Electrolytes
Chloride
Chloride
ammonium chloride intravenous
Electrolyte Mixtures
Electrolytes Parenteral
ISOLYTE-S PH 7.4
Potassium
Potassium
KLOR-CON ORAL TABLET EXTENDEDRELEASE
KLOR-CON M10
KLOR-CON M15
K-TABS
potassium chloride crys er oral tablet extendedrelease 10 MEQ
potassium chloride er oral capsule extended release 10 MEQ
Page 44
TIER
NOTES
T2
T5
PA
T4
T3
T4
T4
T4
T3
T4
T2
T4
T4
ST
ST
ST
ST
ST
ST
T2
T2
T2
T2
T2
T2
T2
T2
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Mouth/Throat/Dental Agents
Anti-Infectives - Throat
Anti-Infectives - Throat
clotrimazole mouth/throat lozenge
Antiseptics - Mouth/Throat
Antiseptics - Mouth/Throat
chlorhexidine gluconate mouth/throat
Steroids - Mouth/Throat
Steroids - Mouth/Throat
triamcinolone acetonide mouth/throat
Throat Products - Misc.
Saliva Stimulants
pilocarpine hcl oral
Musculoskeletal Therapy Agents
Central Muscle Relaxants
Central Muscle Relaxants
baclofen oral
carisoprodol oral tablet 350 MG
chlorzoxazone oral tablet 500 MG
cyclobenzaprine hcl oral tablet 10 MG
methocarbamol oral
SKELAXIN
tizanidine hcl oral tablet
tizanidine hcl oral capsule 2 MG, 4 MG
Direct Muscle Relaxants
Direct Muscle Relaxants
dantrolene sodium oral
Nasal Agents - Systemic And Topical
Nasal Antiallergy
Nasal Antihistamines
azelastine hcl nasal solution 137 MCG/SPRAY
PATANASE
Nasal Steroids
Nasal Steroids
fluticasone propionate nasal
NASONEX
Page 45
TIER
NOTES
T2
T2
T2
T2
T2
T2
T2
T2
T2
T4
T2
T3
ST
T3
T3
T4
ST
T2
T4
ST
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Page 46
TIER
OMNARIS
triamcinolone acetonide nasal
VERAMYST
T4
T2
T4
Sympathomimetic Decongestants
Topical Decongestants
TYZINE NASAL SOLUTION 0.05 %
T3
Neuromuscular Agents
Als Agents
Benzathiazoles
RILUTEK
Ophthalmic Agents
Beta-Blockers - Ophthalmic
Beta-Blockers - Ophthalmic Combinations
COMBIGAN
dorzolamide hcl-timolol mal
dorzolamide hcl-timolol mal pf
Beta-Blockers - Ophthalmic
betaxolol hcl ophthalmic solution
BETOPTIC-S
carteolol hcl
levobunolol hcl ophthalmic solution 0.5 %
metipranolol
timolol hemihydrate
timolol maleate ophthalmic gel forming solution 0.25 %
timolol maleate ophthalmic solution 0.25 %, 0.5 %
Miotics
Miotics - Cholinesterase Inhibitors
PHOSPHOLINE IODIDE
Miotics - Direct Acting
PILOPINE HS
Ophthalmic Adrenergic Agents
Ophthalmic Selective Alpha Adrenergic Agonists
ALPHAGAN P OPHTHALMIC SOLUTION 0.1 %
apraclonidine hcl ophthalmic solution 0.5 %
brimonidine tartrate ophthalmic solution 0.15 %, 0.2 %
Ophthalmic Anti-Infectives
T5
NOTES
ST
ST
PA
T4
T3
T3
T3
T3
T2
T2
T2
T3
T2
T2
T4
T3
T4
T4
T3
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Ophthalmic Antibiotics
bacitracin ophthalmic
BESIVANCE
ciprofloxacin hcl ophthalmic solution
erythromycin ophthalmic
gentamicin sulfate ophthalmic solution
levofloxacin ophthalmic solution 0.5 %
MOXEZA
ofloxacin
tobramycin sulfate ophthalmic solution
VIGAMOX
ZYMAXID
Ophthalmic Antifungal
NATACYN
Ophthalmic Antivirals
trifluridine ophthalmic
ZIRGAN
Ophthalmic Sulfonamides
sulfacetamide sodium ophthalmic
Ophthalmic Immunomodulators
Ophthalmic Immunomodulators
RESTASIS
Ophthalmic Local Anesthetics
Ophthalmic Local Anesthetics
proparacaine hcl ophthalmic
Ophthalmic Steroids
Ophthalmic Steroid Combinations
TOBRADEX OPHTHALMIC OINTMENT
Ophthalmic Steroids
dexamethasone sodium phosphate ophthalmic
DUREZOL
FML LIQUIFILM
LOTEMAX OPHTHALMIC OINTMENT
LOTEMAX OPHTHALMIC SUSPENSION
OMNIPRED
prednisolone acetate ophthalmic suspension 1 %
Page 47
TIER
NOTES
T2
T4
T2
T2
T2
T2
T3
T2
T2
T3
T4
T4
T3
T4
T2
T4
T3
T4
T2
T4
T3
T4
T4
T5
T2
PA
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
prednisolone sodium phosphate ophthalmic
VEXOL
Ophthalmics - Misc.
Ophthalmic Antiallergic
ALOCRIL
ALOMIDE
azelastine hcl ophthalmic
BEPREVE
cromolyn sodium ophthalmic
EMADINE
epinastine hcl
LASTACAFT
PATADAY
PATANOL
Ophthalmic Carbonic Anhydrase Inhibitors
AZOPT
dorzolamide hcl
Ophthalmic Nonsteroidal Anti-Inflammatory Agents
diclofenac sodium ophthalmic
flurbiprofen sodium
ketorolac tromethamine ophthalmic solution 0.4 %, 0.5 %
NEVANAC
Prostaglandins - Ophthalmic
Prostaglandins - Ophthalmic
latanoprost
LUMIGAN OPHTHALMIC SOLUTION 0.01 %
TRAVATAN Z
ZIOPTAN
Otic Agents
Otic Agents - Miscellaneous
Otic Agents - Miscellaneous
acetic acid otic
Otic Anti-Infectives
Otic Anti-Infectives
ofloxacin
Otic Combinations
Page 48
TIER
NOTES
T3
T4
T4
T4
T3
T4
T2
T4
T3
T4
T4
T4
T4
T2
T3
T2
T2
T4
T2
T4
T4
T4
ST
ST
T2
T2
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Otic Steroid-Anti-Infective Combinations
CIPRO HC
CIPRODEX
COLY-MYCIN S
neomycin-polymyxin-hc otic solution 3.5-10000-1
neomycin-polymyxin-hc otic suspension
Otic Steroids
Otic Steroids
DERMOTIC
hydrocortisone-acetic acid
Passive Immunizing Agents
Immune Serums
Immune Serums
CARIMUNE NF
GAMMAGARD INJECTION SOLUTION 30 GM/300ML
Penicillins
Aminopenicillins
Aminopenicillins
amoxicillin oral capsule
amoxicillin oral suspension reconstituted 125 MG/5ML, 400 MG/5ML
amoxicillin oral tablet chewable 125 MG
amoxicillin oral tablet
amoxicillin oral tablet chewable 250 MG
ampicillin oral capsule
ampicillin oral suspension reconstituted
ampicillin sodium intravenous solution reconstituted 10 GM
Natural Penicillins
Natural Penicillins
penicillin v potassium oral solution reconstituted 125 MG/5ML
penicillin v potassium oral tablet
Penicillin Combinations
Penicillin Combinations
amoxicillin-pot clavulanate oral suspension reconstituted 200-28.5 MG/5ML,
250-62.5 MG/5ML, 400-57 MG/5ML, 600-42.9 MG/5ML
amoxicillin-pot clavulanate oral tablet
amoxicillin-pot clavulanate oral tablet chewable
Page 49
TIER
NOTES
T4
T3
T4
T2
T2
T3
T2
T5
T5
PA
PA
T1
T1
T1
T2
T2
T2
T3
T5
PA
T1
T1
T2
T2
T2
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Penicillinase-Resistant Penicillins
Penicillinase-Resistant Penicillins
dicloxacillin sodium
Progestins
Progestins
Progestins
medroxyprogesterone acetate oral
norethindrone acetate oral
progesterone micronized oral capsule 100 MG
PROVERA ORAL TABLET 10 MG
Psychotherapeutic And Neurological Agents - Misc.
Agents For Chemical Dependency
Alcohol Deterrents
CAMPRAL
disulfiram oral
Anti-Cataplectic Agents
Anti-Cataplectic Agents
XYREM
Antidementia Agents
Cholinomimetics - AChE Inhibitors
donepezil hcl oral tablet 10 MG, 5 MG
donepezil hcl oral tablet dispersible
galantamine hydrobromide
RAZADYNE ER ORAL CAPSULE EXTENDED RELEASE 24 HOUR 24
MG
rivastigmine tartrate oral capsule
N-Methyl-D-Aspartate (NMDA) Receptor Antagonists
NAMENDA
NAMENDA TITRATION PAK
Page 50
TIER
NOTES
T2
T2
T3
T3
T2
T4
T4
T4
PA
T2
T2
T3
T3
T3
T3
T3
Fibromyalgia Agents
Fibromyalgia Agent - SNRIs
SAVELLA
SAVELLA TITRATION PACK
T4
T4
Movement Disorder Drug Therapy
Movement Disorder Drug Therapy
XENAZINE
T5
PA
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Multiple Sclerosis Agents
Multiple Sclerosis Agents - Interferons
AVONEX
REBIF TITRATION PACK
Multiple Sclerosis Agents - Monoclonal Antibodies
TYSABRI
Multiple Sclerosis Agents - Potassium Channel Blockers
AMPYRA
Multiple Sclerosis Agents
COPAXONE
Sphingosine 1-Phosphate (S1P) Receptor Modulators
GILENYA
Postherpetic Neuralgia (PHN) Agents
Postherpetic Neuralgia (PHN) Agents
GRALISE STARTER
Premenstrual Dysphoric Disorder (PMDD) Agents
Premenstrual Dysphoric Disorder (PMDD) Agents - SSRIs
fluoxetine hcl (pmdd) oral capsule 20 MG
fluoxetine hcl (pmdd) oral capsule 10 MG
Pseudobulbar Affect (PBA) Agents
Pseudobulbar Affect Agent Combinations
NUEDEXTA
Psychotherapeutic And Neurological Agents - Misc.
Psychotherapeutic And Neurological Agents - Misc.
ergoloid mesylates oral
ORAP
Respiratory Agents - Misc.
Alpha-Proteinase Inhibitor (Human)
Alpha-Proteinase Inhibitor (Human)
ZEMAIRA
Sulfonamides
Sulfonamides
Sulfonamides
sulfadiazine oral
Tetracyclines
Tetracyclines
Page 51
TIER
NOTES
T5
T5
PA
PA
T5
PA
T5
PA
T5
PA
T5
PA
T5
PA
T1
T2
T5
PA
T2
T3
T5
PA
T4
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Tetracyclines
demeclocycline hcl oral
doxycycline hyclate oral tablet 100 MG
doxycycline monohydrate oral tablet 50 MG
minocycline hcl oral capsule 75 MG
minocycline hcl oral tablet
tetracycline hcl oral
Thyroid Agents
Antithyroid Agents
Antithyroid Agents
methimazole oral
propylthiouracil oral
Thyroid Hormones
Thyroid Hormones
levothyroxine sodium oral tablet
liothyronine sodium oral
SYNTHROID
Ulcer Drugs
Antispasmodics
Antispasmodics
dicyclomine hcl oral
Belladonna Alkaloids
atropine sulfate injection solution 0.05 MG/ML
Quaternary Anticholinergics
CANTIL
glycopyrrolate oral tablet 1 MG, 2 MG
methscopolamine bromide oral tablet 2.5 MG
propantheline bromide oral
H-2 Antagonists
H-2 Antagonists
cimetidine oral tablet 800 MG
cimetidine hcl oral
famotidine oral tablet 20 MG, 40 MG
nizatidine oral capsule
ranitidine hcl oral capsule
ranitidine hcl oral tablet 300 MG
Page 52
TIER
NOTES
T3
T2
T2
T2
T2
T1
T2
T2
T2
T2
T3
T2
T4
T4
T3
T3
T4
T3
T2
T2
T3
T1
T1
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Misc. Anti-Ulcer
Misc. Anti-Ulcer
sucralfate oral tablet
Proton Pump Inhibitors
Proton Pump Inhibitors
DEXILANT
lansoprazole oral capsule delayed release 30 MG
omeprazole oral capsule delayed release 10 MG, 40 MG
pantoprazole sodium oral tablet delayed release 20 MG
Ulcer Drugs - Prostaglandins
Ulcer Drugs - Prostaglandins
misoprostol oral tablet 200 MCG
Urinary Anti-Infectives
Urinary Anti-Infectives
Urinary Anti-Infectives
methenamine hippurate
MONUROL
nitrofurantoin macrocrystal oral capsule 50 MG
nitrofurantoin monohyd macro
Urinary Antispasmodics
Urinary Antispasmodic - Antimuscarinics (Anticholinergic)
Urinary Antispasmodic - Antimuscarinic (Anticholinergic)
DETROL LA ORAL CAPSULE EXTENDED RELEASE 24 HOUR 2 MG
Urinary Antispasmodics - Cholinergic Agonists
Urinary Antispasmodics - Cholinergic Agonists
bethanechol chloride oral
Urinary Antispasmodics
Urinary Antispasmodics
bethanechol chloride oral
DETROL ORAL TABLET 1 MG
ENABLEX
flavoxate hcl
oxybutynin chloride oral tablet
trospium chloride
VESICARE
Page 53
TIER
NOTES
T2
T3
T3
T2
T2
ST
T2
T2
T4
T2
T2
T4
ST
T2
T2
T4
T4
T3
T1
T4
T4
ST
ST
ST
ST
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
DRUG NAME
Vaginal Products
Vaginal Anti-Infectives
Imidazole-Related Antifungals
terconazole vaginal cream 0.4 %
ZAZOLE VAGINAL CREAM
Vaginal Anti-Infectives
clindamycin phosphate vaginal cream
metronidazole vaginal
Vaginal Estrogens
Vaginal Estrogens
PREMARIN VAGINAL
VAGIFEM VAGINAL TABLET 10 MCG
Vasopressors
Anaphylaxis Therapy Agents
Anaphylaxis Therapy Agents
EPIPEN
EPIPEN JR
Vasopressors
Vasopressors
midodrine hcl
Page 54
TIER
NOTES
T2
T3
T2
T2
T3
T3
T3
T3
T3
PA = Prior Authorization required | ST = Step Therapy required | QL = Quantity Limit applies
SP = Medication must be obtained through a specialty pharmacy | MD=Medication is a maintenance medication
(1/2) = Certain strengths may be eligible for the Pill-Splitting program. Call Customer Service for details.
Health First—ACA 5-Tier Drug List
Page 55
Index
8-Mop .....................................................................34
Abilify.....................................................................25
Abilify Discmelt .....................................................25
Acanya ....................................................................32
Acarbose .................................................................14
Acebutolol HCl .......................................................29
AcetaZOLAMIDE ..................................................37
AcetaZOLAMIDE Sodium.....................................37
Acetic Acid .............................................................48
Acetylcysteine ........................................................32
Actemra ....................................................................6
Actimmune .............................................................23
Actonel ...................................................................37
Actos .......................................................................14
Acyclovir ................................................................27
Adagen ....................................................................30
Adapalene ...............................................................32
Adcirca ...................................................................31
Advair Diskus .........................................................10
Advair HFA ............................................................10
Afinitor ...................................................................22
Aggrenox ................................................................42
Albenza .....................................................................8
Albuterol Sulfate.....................................................10
Alclometasone Dipropionate ..................................34
Aldara .....................................................................36
Alendronate Sodium ...............................................37
Alfuzosin HCl ER ...................................................41
Alinia ......................................................................19
Allopurinol..............................................................41
Alocril .....................................................................48
Alomide ..................................................................48
Alphagan P .............................................................46
Altabax ...................................................................33
Amantadine HCl .....................................................23
Amcinonide ............................................................35
AMILoride HCl ......................................................37
Amiodarone HCl.......................................................9
Amitiza ...................................................................40
Amitriptyline HCl ...................................................13
AmLODIPine Besylate ...........................................30
Ammonium Chloride ..............................................44
Ammonium Lactate ................................................35
Amnesteem .............................................................32
Amoxapine..............................................................13
Amoxicillin .............................................................49
Amoxicillin-Pot Clavulanate ..................................49
Amphetamine-Dextroamphetamine ..........................5
Ampicillin ...............................................................49
Ampicillin Sodium .................................................49
Ampyra ...................................................................51
Anagrelide HCl .......................................................42
Anastrozole .............................................................22
AndroGel .................................................................. 8
Androxy .................................................................... 8
Anzemet.................................................................. 16
Aplenzin ................................................................. 12
Apraclonidine HCl ................................................. 46
Aptivus ................................................................... 26
Aranesp (Albumin Free) ......................................... 42
Arcalyst .................................................................... 6
Arcapta Neohaler .................................................... 10
Asmanex 120 Metered Doses ................................. 10
Asmanex 14 Metered Doses ................................... 10
Asmanex 30 Metered Doses ................................... 10
Asmanex 60 Metered Doses ................................... 10
Atacand ................................................................... 18
Atenolol .................................................................. 29
Atorvastatin Calcium .............................................. 17
Atovaquone-Proguanil HCl .................................... 20
Atropine Sulfate ..................................................... 52
Avandia .................................................................. 14
Avelox .................................................................... 39
Avodart ................................................................... 41
Avonex ................................................................... 51
Axert ....................................................................... 44
Azasan .................................................................... 29
AzaTHIOprine ........................................................ 29
Azelastine HCl ................................................. 45, 48
Azilect .................................................................... 24
Azithromycin .......................................................... 43
Azopt ...................................................................... 48
Bacitracin................................................................ 47
Baclofen.................................................................. 45
Balsalazide Disodium ............................................. 40
Banzel ..................................................................... 11
Baraclude ................................................................ 27
Benazepril HCl ....................................................... 18
Benicar.................................................................... 18
BenzamycinPak ...................................................... 32
Benztropine Mesylate ............................................. 23
Bepreve ................................................................... 48
Besivance................................................................ 47
Betamethasone Dipropionate Aug .......................... 35
Betaxolol HCl ................................................... 29, 46
Bethanechol Chloride ............................................. 53
Betoptic-S ............................................................... 46
Bicalutamide ........................................................... 22
Biltricide ................................................................... 8
Bisoprolol Fumarate ............................................... 29
Brilinta .................................................................... 41
Brimonidine Tartrate .............................................. 46
Bromocriptine Mesylate ......................................... 23
Brovana .................................................................. 10
Budeprion SR ......................................................... 12
Budesonide ............................................................. 10
Health First—ACA 5-Tier Drug List
Bumetanide .............................................................37
Buphenyl.................................................................39
Buprenorphine HCl...................................................7
BuPROPion HCl .....................................................12
BusPIRone HCl ........................................................9
Butorphanol Tartrate.................................................7
Bydureon ................................................................14
Byetta 10 MCG Pen ................................................14
Byetta 5 MCG Pen ..................................................14
Bystolic ...................................................................29
Cabergoline.............................................................39
Calcipotriene...........................................................34
Calcitriol .................................................................38
Calcium Acetate .....................................................40
Campral ..................................................................50
Cantil ......................................................................52
Capastat Sulfate ......................................................21
Caprelsa ..................................................................22
Captopril .................................................................18
CarBAMazepine .....................................................11
Carbidopa-Levodopa ..............................................24
Carbidopa-Levodopa ER ........................................24
Carbinoxamine Maleate ..........................................16
Cardizem CD ..........................................................30
Carimune NF ..........................................................49
Carisoprodol ...........................................................45
Carteolol HCl..........................................................46
Cartia XT ................................................................30
Carvedilol ...............................................................29
Cedax ......................................................................31
Cefaclor ..................................................................31
Cefadroxil ...............................................................31
CeFAZolin Sodium.................................................31
Cefdinir ...................................................................31
Cefpodoxime Proxetil .............................................31
CefTRIAXone Sodium ...........................................31
Cefuroxime Axetil ..................................................31
CeleBREX ................................................................6
CellCept ..................................................................28
Celontin ..................................................................12
Cenestin ..................................................................39
Cephalexin ..............................................................31
Cesamet ..................................................................16
Chemet ....................................................................15
Chlorhexidine Gluconate ........................................45
Chloroquine Phosphate ...........................................20
Chlorothiazide ........................................................37
ChlorproMAZINE HCl...........................................25
ChlorproPAMIDE ..................................................15
Chlorthalidone ........................................................37
Chlorzoxazone ........................................................45
Ciclopirox ...............................................................33
Ciclopirox Olamine ................................................33
Cilostazol ................................................................41
Cimetidine ..............................................................52
Cimetidine HCl .......................................................52
Page 56
Cipro HC ................................................................ 49
Ciprodex ................................................................. 49
Ciprofloxacin HCl ............................................ 39, 47
Citalopram Hydrobromide...................................... 13
Claravis ................................................................... 32
Clarithromycin........................................................ 43
Clemastine Fumarate ........................................ 16, 17
Clindamycin HCl .................................................... 20
Clindamycin Phosphate .................................... 32, 54
Clobetasol Propionate............................................. 35
Cloderm Pump ........................................................ 35
ClomiPRAMINE HCl ............................................ 13
CloNIDine HCl....................................................... 18
Clopidogrel Bisulfate ............................................. 42
Clotrimazole ........................................................... 45
Clotrimazole-Betamethasone ................................. 33
CloZAPine .............................................................. 25
Coartem .................................................................. 20
Colchicine-Probenecid ........................................... 41
Colcrys.................................................................... 41
Colestipol HCl ........................................................ 17
Colocort .................................................................... 8
Coly-Mycin S ......................................................... 49
Combigan ............................................................... 46
Comtan ................................................................... 23
Concerta.................................................................... 5
Condylox ................................................................ 36
Copaxone ................................................................ 51
Coreg CR ................................................................ 29
Cortisone Acetate ................................................... 32
Cortisporin .............................................................. 33
Creon ...................................................................... 37
Crestor .................................................................... 17
Crixivan .................................................................. 26
Cromolyn Sodium ........................................ 9, 40, 48
Cutivate .................................................................. 35
Cyclobenzaprine HCl ............................................. 45
Cyclophosphamide ................................................. 21
Cycloset .................................................................. 14
CycloSPORINE ...................................................... 28
CycloSPORINE Modified ...................................... 28
Cyklokapron ........................................................... 42
Cymbalta ................................................................ 13
Cyproheptadine HCl ............................................... 17
Cystagon ................................................................. 41
Danazol ..................................................................... 8
Dantrolene Sodium ................................................. 45
Dapsone .................................................................. 20
Daraprim ................................................................. 20
Demeclocycline HCl .............................................. 52
Denavir ................................................................... 34
Depakote ER........................................................... 12
Depen Titratabs ...................................................... 28
Depo-Testosterone.................................................... 8
Derma-Smoothe/FS Scalp ...................................... 35
DermOtic ................................................................ 49
Health First—ACA 5-Tier Drug List
Desipramine HCl ....................................................13
Desmopressin Acetate ............................................39
Desoximetasone ......................................................35
Detrol ......................................................................53
Detrol LA................................................................53
Dexamethasone .......................................................32
Dexamethasone Sodium Phosphate ........................47
Dexilant ..................................................................53
Dexmethylphenidate HCl .........................................5
Dextroamphetamine Sulfate .....................................5
Dibenzyline.............................................................18
Diclofenac Potassium ...............................................6
Diclofenac Sodium .............................................6, 48
Dicloxacillin Sodium ..............................................50
Dicyclomine HCl ....................................................52
Didanosine ..............................................................26
Dificid .....................................................................44
Diflunisal ..................................................................7
Digoxin ...................................................................30
Dihydroergotamine Mesylate .................................44
Dilantin ...................................................................12
Dilatrate-SR ..............................................................8
Diltiazem HCl .........................................................30
Diovan ....................................................................18
Dipentum ................................................................40
Diphenoxylate-Atropine .........................................15
Dipyridamole ..........................................................42
Disopyramide Phosphate ..........................................9
Disulfiram ...............................................................50
Diuril.......................................................................37
Divalproex Sodium .................................................12
Donepezil HCl ........................................................50
Dorzolamide HCl ....................................................48
Dorzolamide HCl-Timolol Mal ..............................46
Dorzolamide HCl-Timolol Mal PF .........................46
Doxazosin Mesylate ...............................................19
Doxepin HCl ...........................................................13
Doxycycline Hyclate ..............................................52
Doxycycline Monohydrate .....................................52
Dronabinol ..............................................................16
Droxia .....................................................................42
Dulera .....................................................................10
Durezol ...................................................................47
Dyrenium ................................................................37
E.E.S. 400 ...............................................................43
Econazole Nitrate ...................................................33
Edarbi .....................................................................18
Edecrin ....................................................................37
Edurant ...................................................................26
Effient .....................................................................42
Elidel.......................................................................36
Ella ..........................................................................31
Elmiron ...................................................................41
Emadine ..................................................................48
Emcyt ......................................................................22
Emend .....................................................................16
Page 57
Emsam .................................................................... 13
Emtriva ................................................................... 27
Enablex ................................................................... 53
Enalapril Maleate ................................................... 18
Enbrel ....................................................................... 6
Enjuvia.................................................................... 39
Enoxaparin Sodium ................................................ 11
Epiduo .................................................................... 32
Epinastine HCl ....................................................... 48
EPINEPHrine HCl .................................................. 10
EpiPen .................................................................... 54
EpiPen Jr................................................................. 54
Epivir ...................................................................... 27
Epivir HBV............................................................. 27
Eplerenone .............................................................. 19
Eprosartan Mesylate ............................................... 18
Epzicom .................................................................. 26
Ergoloid Mesylates ................................................. 51
Errin ........................................................................ 31
Ertaczo .................................................................... 33
Ery .......................................................................... 32
Erythromycin .................................................... 32, 47
Erythromycin Base ................................................. 44
Escitalopram Oxalate.............................................. 13
Estradiol.................................................................. 39
Estropipate .............................................................. 39
Ethambutol HCl ...................................................... 21
Ethosuximide .......................................................... 12
Etidronate Disodium............................................... 37
Etodolac .................................................................... 6
Eurax ...................................................................... 36
Evista ...................................................................... 38
Exelderm ................................................................ 33
Exemestane ............................................................. 22
Exjade ..................................................................... 15
Factive .................................................................... 40
Famciclovir ............................................................. 28
Famotidine .............................................................. 52
Fanapt ..................................................................... 24
Fanapt Titration Pack ............................................. 24
Fareston .................................................................. 22
FazaClo ................................................................... 25
Felbamate ............................................................... 12
Felodipine ER ......................................................... 30
Fenofibrate.............................................................. 17
Fenofibrate Micronized .......................................... 17
Fenoprofen Calcium ................................................. 6
FentaNYL ................................................................. 7
FentaNYL Citrate ..................................................... 7
Finacea.................................................................... 36
Finasteride .............................................................. 41
FlavoxATE HCl ..................................................... 53
Flecainide Acetate .................................................... 9
Flovent Diskus ........................................................ 10
Flovent HFA ........................................................... 10
Fluconazole ............................................................ 16
Health First—ACA 5-Tier Drug List
Flucytosine..............................................................16
Fludarabine Phosphate ............................................21
Fludrocortisone Acetate ..........................................32
Fluocinolone Acetonide ..........................................35
Fluocinonide ...........................................................35
Fluorouracil ............................................................21
FLUoxetine HCl .....................................................13
FLUoxetine HCl (PMDD) ......................................51
FluPHENAZine HCl...............................................25
Flurazepam HCl ......................................................43
Flurbiprofen ..............................................................6
Flurbiprofen Sodium...............................................48
Flutamide ................................................................22
Fluticasone Propionate .....................................35, 45
Fluvastatin Sodium .................................................17
FluvoxaMINE Maleate ...........................................13
FML Liquifilm ........................................................47
Focalin XR................................................................5
Fondaparinux Sodium.............................................11
Foradil Aerolizer.....................................................10
Forteo ......................................................................38
Fosinopril Sodium ..................................................18
Fosrenol ..................................................................40
Frova .......................................................................44
Furosemide .............................................................37
Fuzeon ....................................................................26
Gabapentin ..............................................................11
Gabitril ....................................................................12
Galantamine Hydrobromide ...................................50
Gammagard ............................................................49
Gemfibrozil.............................................................17
Gengraf ...................................................................28
Gentamicin Sulfate ...........................................33, 47
Gilenya ...................................................................51
Gleevec ...................................................................22
Glimepiride .............................................................15
GlipiZIDE ...............................................................15
GlipiZIDE ER .........................................................15
GlipiZIDE XL.........................................................15
GlucaGen HypoKit .................................................14
GlyBURIDE ...........................................................15
GlyBURIDE Micronized ........................................15
Glycopyrrolate ........................................................52
Glyset ......................................................................14
Gralise Starter .........................................................51
Granisetron HCl ......................................................16
Granisol ..................................................................16
Griseofulvin Microsize ...........................................16
GuanFACINE HCl .................................................19
Halobetasol Propionate ...........................................35
Halog ......................................................................35
Haloperidol .............................................................25
Haloperidol Decanoate ...........................................25
Haloperidol Lactate ................................................25
Hectorol ..................................................................38
Heparin Sodium (Porcine) ......................................11
Page 58
Hepsera ................................................................... 27
Hexalen ................................................................... 21
HumaLOG Mix 50/50 ............................................ 14
HumuLIN R U-500 (CONCENTRATED) ............. 15
HydrALAZINE HCl ............................................... 19
Hydrochlorothiazide ............................................... 37
Hydrocortisone ............................................. 8, 32, 35
Hydrocortisone Valerate ......................................... 35
Hydrocortisone-Acetic Acid ................................... 49
HYDROmorphone HCl ............................................ 7
Hydroxychloroquine Sulfate .................................. 20
Hydroxyurea ........................................................... 23
HydrOXYzine HCl ................................................... 9
HydrOXYzine Pamoate ............................................ 9
Ibandronate Sodium ............................................... 38
Ibuprofen .................................................................. 6
Imipramine HCl ...................................................... 13
Incivek .................................................................... 27
Increlex ................................................................... 38
Indapamide ............................................................. 37
Indomethacin ............................................................ 6
Infergen .................................................................. 27
InnoPran XL ........................................................... 29
Intelence ................................................................. 26
Intron-A .................................................................. 23
Intuniv ...................................................................... 5
Invega Sustenna ...................................................... 24
Invirase ................................................................... 26
Ipratropium Bromide ................................................ 9
Irbesartan ................................................................ 18
Isentress .................................................................. 26
Isolyte-S pH 7.4 ...................................................... 44
Isoniazid ................................................................. 21
Isosorbide Dinitrate .................................................. 8
Isosorbide Dinitrate ER ............................................ 8
Isosorbide Mononitrate............................................. 8
Isradipine ................................................................ 30
Jakafi ...................................................................... 22
Januvia .................................................................... 14
Jentadueto ............................................................... 14
Kaletra .................................................................... 26
Kayexalate .............................................................. 29
Kepivance ............................................................... 23
Ketek ...................................................................... 20
Ketoconazole .................................................... 16, 33
Ketoprofen ................................................................ 6
Ketorolac Tromethamine .................................... 6, 48
Klor-Con ................................................................. 44
Klor-Con M10 ........................................................ 44
Klor-Con M15 ........................................................ 44
K-Tabs .................................................................... 44
Kuvan ..................................................................... 39
Labetalol HCl ......................................................... 29
Lactulose ................................................................ 43
LamiVUDine .......................................................... 27
Lamivudine-Zidovudine ......................................... 26
Health First—ACA 5-Tier Drug List
LamoTRIgine..........................................................11
Lansoprazole ...........................................................53
Lastacaft .................................................................48
Latanoprost .............................................................48
Latuda .....................................................................24
Leflunomide..............................................................6
Letairis ....................................................................31
Letrozole .................................................................22
Leucovorin Calcium ...............................................23
Leukeran .................................................................21
Leukine ...................................................................42
Leuprolide Acetate .................................................22
Levalbuterol HCl ....................................................10
Levatol ....................................................................29
Levemir...................................................................15
LevETIRAcetam .....................................................11
LevETIRAcetam ER...............................................11
Levobunolol HCl ....................................................46
Levocetirizine Dihydrochloride ..............................17
Levofloxacin .....................................................40, 47
Levorphanol Tartrate ................................................7
Levothyroxine Sodium ...........................................52
Lexiva .....................................................................26
Lialda ......................................................................40
Lidocaine HCl.........................................................36
Lidocaine-Prilocaine ...............................................36
Lindane ...................................................................36
Liothyronine Sodium ..............................................52
Lisinopril ................................................................18
Lithium Carbonate ..................................................24
Lithium Carbonate ER ............................................24
Livalo ......................................................................17
Lodosyn ..................................................................23
Loperamide HCl .....................................................15
Losartan Potassium .................................................18
Lotemax ..................................................................47
Lotronex .................................................................40
Lovastatin ...............................................................17
Lovaza ....................................................................17
Loxapine Succinate.................................................25
Lufyllin ...................................................................10
Lumigan ..................................................................48
Lumizyme ...............................................................38
Lunesta ...................................................................43
Lyrica ......................................................................11
Lysodren .................................................................21
Malarone .................................................................20
Malathion ................................................................36
Maprotiline HCl ......................................................12
Marplan...................................................................13
Matulane .................................................................23
Maxair Autohaler ....................................................10
Maxalt .....................................................................44
Meclizine HCl.........................................................16
Meclofenamate Sodium ............................................6
MedroxyPROGESTERone Acetate ........................50
Page 59
Mefenamic Acid ....................................................... 6
Mefloquine HCl ...................................................... 20
Megestrol Acetate................................................... 22
Meloxicam ................................................................ 6
Melphalan HCl ....................................................... 21
Menest .................................................................... 39
Mentax .................................................................... 33
Meperidine HCl ........................................................ 7
Meprobamate ............................................................ 9
Mepron ................................................................... 19
Mercaptopurine ...................................................... 21
Meropenem ............................................................. 19
Mestinon ................................................................. 20
Metaproterenol Sulfate ........................................... 10
MetFORMIN HCl .................................................. 14
Methadone HCl ........................................................ 7
Methamphetamine HCl ............................................ 5
Methazolamide ....................................................... 37
Methenamine Hippurate ......................................... 53
Methimazole ........................................................... 52
Methocarbamol ....................................................... 45
Methotrexate Sodium ............................................. 21
Methotrexate Sodium (PF) ..................................... 21
Methscopolamine Bromide .................................... 52
Methyclothiazide .................................................... 37
Methyldopa ............................................................. 19
Methylin ................................................................... 5
Methylphenidate HCl ............................................... 5
MethylPREDNISolone ........................................... 32
MethylPREDNISolone (Pak) ................................. 32
Metipranolol ........................................................... 46
Metoclopramide HCl .............................................. 40
Metolazone ............................................................. 37
Metoprolol Tartrate ................................................ 29
MetroNIDAZOLE ............................................ 19, 54
Miacalcin ................................................................ 38
Micardis .................................................................. 18
Midodrine HCl ....................................................... 54
Migergot ................................................................. 44
Minocycline HCl .................................................... 52
Minoxidil ................................................................ 19
Mirapex ER ............................................................ 24
Mirtazapine ............................................................. 12
Misoprostol ............................................................. 53
Moexipril HCl ........................................................ 18
Mometasone Furoate .............................................. 35
Monurol .................................................................. 53
Morphine Sulfate ...................................................... 7
Morphine Sulfate ER ................................................ 7
Morphine Sulfate ER Beads ..................................... 7
Motofen .................................................................. 15
MoviPrep ................................................................ 43
Moxeza ................................................................... 47
Multaq ...................................................................... 9
Mycobutin .............................................................. 21
Mycophenolate Mofetil .......................................... 28
Health First—ACA 5-Tier Drug List
Myfortic ..................................................................28
Mytelase .................................................................20
Nabumetone ..............................................................6
Nadolol ...................................................................29
Naftin ......................................................................33
Naglazyme ..............................................................39
Naltrexone HCl .......................................................15
Namenda .................................................................50
Namenda Titration Pak ...........................................50
Naproxen ..................................................................6
Naproxen Sodium .....................................................6
Naratriptan HCl ......................................................44
Nasonex ..................................................................45
Natacyn ...................................................................47
Nateglinide..............................................................15
Nefazodone HCl .....................................................13
Neomycin Sulfate .....................................................5
Neomycin-Polymyxin-HC ......................................49
Neulasta ..................................................................42
Neupogen ................................................................42
Nevanac ..................................................................48
Nevirapine ..............................................................26
NexAVAR ..............................................................22
Niacor .....................................................................18
NiCARdipine HCl ..................................................30
NIFEdipine .............................................................30
Nilandron ................................................................22
NiMODipine ...........................................................30
Nisoldipine ER .......................................................30
Nitrofurantoin Macrocrystal ...................................53
Nitrofurantoin Monohyd Macro .............................53
Nitrostat ....................................................................8
Nizatidine ...............................................................52
Norethindrone Acetate ............................................50
Noroxin ...................................................................40
Norpace CR ..............................................................9
Nortriptyline HCl ....................................................13
Norvir .....................................................................26
NovoLOG ...............................................................15
NovoLOG Mix 70/30 .............................................15
Noxafil ....................................................................16
Nucynta.....................................................................7
Nucynta ER...............................................................7
Nuedexta .................................................................51
Nulojix ....................................................................29
Nuvigil ......................................................................5
Nystatin.............................................................16, 33
Nystatin-Triamcinolone ..........................................33
Nystop.....................................................................33
Octreotide Acetate ..................................................39
Ofloxacin ....................................................40, 47, 48
OLANZapine ..........................................................25
Olux-E ....................................................................35
Omeprazole.............................................................53
Omnaris ..................................................................46
Omnipred ................................................................47
Page 60
Ondansetron............................................................ 16
Ondansetron HCl .................................................... 16
Onglyza .................................................................. 14
Orap ........................................................................ 51
Orfadin.................................................................... 38
OsmoPrep ............................................................... 43
Oxandrolone ............................................................. 8
Oxaprozin ................................................................. 6
OXcarbazepine ....................................................... 11
Oxistat .................................................................... 33
Oxybutynin Chloride .............................................. 53
OxyCODONE HCl ................................................... 7
Oxycodone-Ibuprofen............................................... 7
Oxymorphone HCl ................................................... 7
Oxymorphone HCl ER ............................................. 7
Pamidronate Disodium ........................................... 38
Panretin ................................................................... 34
Pantoprazole Sodium .............................................. 53
Paromomycin Sulfate ............................................... 5
PARoxetine HCl ER ............................................... 13
Paser ....................................................................... 21
Pataday ................................................................... 48
Patanase .................................................................. 45
Patanol .................................................................... 48
Paxil ........................................................................ 13
Peganone ................................................................ 12
Pegasys ................................................................... 27
Pegasys ProClick .................................................... 27
Peg-Intron ............................................................... 27
Peg-Intron Redipen................................................. 27
Peg-Intron Redipen Pak 4 ....................................... 27
Penicillin V Potassium ........................................... 49
Pentam .................................................................... 19
Pentoxifylline ER ................................................... 41
Perindopril Erbumine ............................................. 18
Permethrin .............................................................. 36
Perphenazine .......................................................... 25
Phenelzine Sulfate .................................................. 13
Phenytoin Sodium Extended .................................. 12
Phospholine Iodide ................................................. 46
Physiolyte ............................................................... 29
Picato ...................................................................... 34
Pilocarpine HCl ...................................................... 45
Pilopine HS............................................................. 46
Pindolol .................................................................. 29
Piroxicam.................................................................. 6
Podofilox ................................................................ 36
Polyethylene Glycol 3350 ...................................... 43
Ponstel ...................................................................... 6
Potassium Chloride Crys ER .................................. 44
Potassium Chloride ER .......................................... 44
Potiga ...................................................................... 11
Pradaxa ................................................................... 11
Pramipexole Dihydrochloride ................................ 24
Prandin.................................................................... 15
Pravastatin Sodium ................................................. 17
Health First—ACA 5-Tier Drug List
Prazosin HCl ...........................................................19
Prednicarbate ..........................................................35
PrednisoLONE........................................................32
PrednisoLONE Acetate ..........................................47
PrednisoLONE Sodium Phosphate .........................48
PredniSONE ...........................................................32
Premarin ...........................................................39, 54
Prevalite ..................................................................17
Prezista ...................................................................26
Priftin ......................................................................21
Primaquine Phosphate ............................................20
Primidone ...............................................................12
Probenecid ..............................................................41
Procainamide HCl.....................................................9
Prochlorperazine .....................................................25
Prochlorperazine Maleate .......................................25
Procrit .....................................................................42
Progesterone Micronized ........................................50
Proglycem ...............................................................14
Prograf ....................................................................28
Prolia.......................................................................38
Promacta .................................................................42
Promethazine HCl...................................................17
Propafenone HCl ......................................................9
Propantheline Bromide ...........................................52
Proparacaine HCl ....................................................47
Propranolol HCl ......................................................29
Propylthiouracil ......................................................52
Protopic...................................................................36
Protriptyline HCl ....................................................14
Proventil HFA.........................................................10
Provera ....................................................................50
Provigil .....................................................................5
Pulmicort Flexhaler ................................................10
Pyridostigmine Bromide .........................................20
Qualaquin ...............................................................20
QUEtiapine Fumarate .............................................25
Quinapril HCl .........................................................18
QuiNIDine Gluconate ER .........................................9
QuiNIDine Sulfate ....................................................9
QuiNIDine Sulfate ER ..............................................9
Ramipril ..................................................................18
Ranexa ......................................................................8
Ranitidine HCl ........................................................52
Rapaflo ...................................................................41
Rapamune ...............................................................28
Razadyne ER ..........................................................50
Rebif Titration Pack................................................51
Reclast ....................................................................38
Rectiv ........................................................................8
Regonol...................................................................20
Regranex .................................................................36
Relenza Diskhaler ...................................................28
Relpax .....................................................................44
Remicade ................................................................40
Remodulin ..............................................................30
Page 61
Renagel ................................................................... 40
Renvela ................................................................... 40
Rescriptor ............................................................... 26
Restasis ................................................................... 47
Retrovir ................................................................... 27
Revlimid ................................................................. 28
Reyataz ................................................................... 26
Ribavirin ................................................................. 27
Ridaura ..................................................................... 5
Rifampin ................................................................. 21
Rifater ..................................................................... 20
Rilutek .................................................................... 46
Rimantadine HCl .................................................... 28
RisperDAL Consta ................................................. 24
RisperiDONE ......................................................... 24
RisperiDONE M-TAB ........................................... 24
Rituxan ................................................................... 21
Rivastigmine Tartrate ............................................. 50
ROPINIRole HCl ................................................... 24
Rozerem.................................................................. 43
Sabril ...................................................................... 12
Samsca .................................................................... 39
SandoSTATIN LAR Depot .................................... 39
Santyl ...................................................................... 36
Saphris .................................................................... 25
Savella .................................................................... 50
Savella Titration Pack............................................. 50
Selegiline HCl ........................................................ 24
Selenium Sulfide .................................................... 34
Selzentry ................................................................. 26
Sensipar .................................................................. 38
Seromycin ............................................................... 21
SEROquel XR ........................................................ 25
Serostim .................................................................. 38
Sertraline HCl ......................................................... 13
Silenor .................................................................... 43
Silvadene ................................................................ 34
Silver Sulfadiazine ................................................. 34
Simvastatin ............................................................. 18
Skelaxin .................................................................. 45
Solaraze .................................................................. 34
Somavert ................................................................. 38
Soriatane ................................................................. 34
Sotalol HCl ............................................................. 29
Spiriva HandiHaler ................................................... 9
Spironolactone ........................................................ 37
Sprycel .................................................................... 22
SSD......................................................................... 34
Stavudine ................................................................ 27
Strattera .................................................................... 5
Stromectol ................................................................ 8
Sucralfate ................................................................ 53
Sulfacetamide Sodium ............................................ 47
SulfADIAZINE ...................................................... 51
Sulfamethoxazole-Trimethoprim ........................... 19
Sulfamylon ............................................................. 34
Health First—ACA 5-Tier Drug List
SulfaSALAzine .......................................................40
Sulindac ....................................................................6
SUMAtriptan Succinate ..........................................44
Suprax .....................................................................31
Suprep Bowel Prep .................................................43
Sustiva ....................................................................26
Sutent ......................................................................22
Synarel ....................................................................38
Synera .....................................................................36
Synthroid ................................................................52
Syprine ....................................................................28
Tabloid ....................................................................21
Taclonex .................................................................35
Tacrolimus ..............................................................28
Tamiflu ...................................................................28
Tamoxifen Citrate ...................................................22
Tamsulosin HCl ......................................................41
Tarceva ...................................................................22
Targretin ...........................................................23, 34
Tasigna ...................................................................22
Tasmar ....................................................................23
Tazorac ...................................................................34
Tekturna ..................................................................19
Terazosin HCl .........................................................19
Terbinafine HCl ......................................................16
Terbutaline Sulfate .................................................10
Terconazole ............................................................54
Testosterone Cypionate ............................................8
Testosterone Enanthate .............................................8
Tetracycline HCl.....................................................52
Thalomid.................................................................28
Theophylline ER ...............................................10, 11
Thioridazine HCl ....................................................25
Thiothixene .............................................................26
Thymoglobulin .......................................................28
Ticlopidine HCl ......................................................42
Tigan .......................................................................16
Tikosyn .....................................................................9
Timolol Hemihydrate .............................................46
Timolol Maleate ...............................................30, 46
TiZANidine HCl .....................................................45
TobraDex ................................................................47
Tobramycin Sulfate ................................................47
TOLAZamide .........................................................15
TOLBUTamide .......................................................15
Tolmetin Sodium ......................................................6
Topiramate ..............................................................12
Torsemide ...............................................................37
Tracleer ...................................................................31
Tradjenta .................................................................14
TraMADol HCl.........................................................7
TraMADol HCl ER ..................................................7
Trandolapril ............................................................18
Tranylcypromine Sulfate ........................................13
Travatan Z...............................................................48
TraZODone HCl .....................................................13
Page 62
Trecator .................................................................. 21
Tretinoin ........................................................... 23, 33
Trexall .................................................................... 21
Triamcinolone Acetonide ........................... 35, 45, 46
Trifluoperazine HCl................................................ 25
Trifluridine ............................................................. 47
Trihexyphenidyl HCl .............................................. 23
Trimethoprim.......................................................... 19
Trizivir .................................................................... 26
Trospium Chloride ................................................. 53
Truvada ................................................................... 26
Tykerb .................................................................... 22
Tysabri .................................................................... 51
Tyzeka .................................................................... 27
Tyzine ..................................................................... 46
Ulesfia .................................................................... 36
Uloric ...................................................................... 41
Ursodiol .................................................................. 40
Vagifem .................................................................. 54
ValACYclovir HCl ................................................. 27
Valcyte.................................................................... 27
Valproic Acid ......................................................... 12
Vancomycin HCl .................................................... 19
Vectical ................................................................... 34
Venlafaxine HCl ..................................................... 13
Venlafaxine HCl ER ............................................... 13
Ventavis .................................................................. 31
Veramyst ................................................................ 46
Verapamil HCl ....................................................... 30
Verapamil HCl ER ................................................. 30
Verapamil HCl ER (CO) ........................................ 30
Veregen .................................................................. 33
VESIcare ................................................................ 53
Vexol ...................................................................... 48
Vfend ...................................................................... 16
Victrelis .................................................................. 27
Videx ...................................................................... 26
Vigamox ................................................................. 47
Viibryd.................................................................... 13
Vimpat .................................................................... 12
Viracept .................................................................. 26
Viread ..................................................................... 27
Voltaren .................................................................. 33
Voriconazole .......................................................... 16
Votrient ................................................................... 22
Vyvanse .................................................................... 5
Warfarin Sodium .................................................... 11
Welchol .................................................................. 17
Xalkori .................................................................... 22
Xarelto .................................................................... 11
Xenazine ................................................................. 50
Xifaxan ................................................................... 19
Xyrem ..................................................................... 50
Zafirlukast .............................................................. 10
Zaleplon .................................................................. 43
Zavesca ................................................................... 42
Health First—ACA 5-Tier Drug List
Zazole .....................................................................54
Zemaira ...................................................................51
Zemplar...................................................................38
Zetia ........................................................................18
Ziagen .....................................................................26
Ziana .......................................................................32
Zidovudine ..............................................................27
Zioptan ....................................................................48
Ziprasidone HCl .....................................................24
Zirgan .....................................................................47
Zolinza ....................................................................22
Page 63
Zolpidem Tartrate ................................................... 43
Zomig ..................................................................... 44
Zomig ZMT ............................................................ 44
Zonalon ................................................................... 34
Zonisamide ............................................................. 12
Zortress ................................................................... 28
Zovirax ................................................................... 34
Zyflo CR ................................................................... 9
Zymaxid.................................................................. 47
Zytiga...................................................................... 21
Zyvox...................................................................... 20
Health First offers health care coverage options through two companies. Health First Health Plans, Inc. offers Medicare Advantage and
Group HMO and POS (point of service) health plans. Health First Insurance, Inc. offers Medigap/Medicare Supplement insurance, as
well as Group and Individual PPO insurance, including Exchange policies.