January 2020 – Formulary Update
Posted on February 10, 2020
Health New England’s formularies can be accessed on healthnewengland.org using the “Find A Drug” tool at the top of the page.
The online formularies are updated throughout the year as changes are made. We have three formularies, one for each line of business – Commercial, Medicare Advantage and BeHealthy Partnership/Medicaid. Each formulary includes the tier assignment for each drug and any drug-specific medication management requirements, including quantity limitations, step therapy requirements and prior authorization requirements.
Most recently, the following medications have been reviewed for our Commercial and BeHealthy Partnership/Medicaid line of business:
|
Brand Name: |
Actemra actipen | Generic: | Tocilizumab |
|
Brand Name |
Anavip | Generic: |
Crotalidae |
|
Brand Name: |
Asparlas | Generic: | Calaspargase |
| Brand Name: | Azedra | Generic: |
lobenaguane |
|
Brand Name: |
Balversa | Generic: | Erdafitinib |
|
Brand Name: |
Belrapzo | Generic: |
Bendamustine |
| Brand Name: | Corlanor sol | Generic: |
Ivabradine |
|
Brand Name: |
Daurismo | Generic: | Glasdegib |
| Brand Name: | Dextenza | Generic: |
Dexmethasone |
|
Brand Name: |
Dsuvia | Generic: | Sufentanil |
|
Brand Name: |
Elzonris | Generic: |
Tagraxofusp-ERZS |
| Brand Name: | Erlotinib | Generic: |
n/a |
|
Brand Name: |
Evenity | Generic: | Romosozumab-AQQG |
|
Brand Name: |
Gamifant | Generic: |
Emapalumab-LZSG |
| Brand Name: | Ilumya | Generic: |
Tildrakizumab-ASMN |
|
Brand Name: |
Imvexxy | Generic: | Estradiol |
| Brand Name: | Kanjinti | Generic: |
Trastuzumab-ANNS |
| Brand Name: | Khapzory | Generic: |
Levoleucovorin |
|
Brand Name: |
Krintafel | Generic: | Tafenoquine |
| Brand Name: | Libtayo | Generic: |
Cemiplimab-RWLC |
| Brand Name: | Lumoxiti | Generic: |
Moxetumomab |
|
Brand Name: |
Nivestym | Generic: | Filgrastim-AAFI |
| Brand Name: | Onpattro | Generic: |
Patisiran |
|
Brand Name: |
Poteligeo | Generic: | Mogamuliziumab-KPKC |
|
Brand Name: |
Prograf granules | Generic: |
Tacrolimus |
| Brand Name: | Qmiiz ODT | Generic: |
Meloxicam |
|
Brand Name: |
Rebinyn | Generic: | Coagulation factor IX |
| Brand Name: | Retacrit | Generic: |
Epoetin Alfa-EPBX |
| Brand Name: | Seysara | Generic: |
Sarecycline |
| Brand Name: | Symdeko 50-75mg | Generic: |
Tezacaftor and Ivacaftor |
|
Brand Name: |
Synojoynt | Generic: |
Sodium Hyaluronate |
|
Brand Name: |
Takhzro | Generic: | Lanadelumab-FLYO |
|
Brand Name: |
Tirosint solution | Generic: |
Levothyroxine |
| Brand Name: | Trazimera | Generic: |
Trastuzumab-QYYP |
|
Brand Name: |
Triluron | Generic: | Sodium Hyaluronate |
| Brand Name: | Ultomiris | Generic: |
Ravulizumab-CWVZ |
| Brand Name: | Vigabatrin | Generic: |
n/a |
| Brand Name: | Zirabev | Generic: |
Bevacizumab-BVZR |
| Brand Name: | Zykadia tablets | Generic: |
Certinib |
