{"id":8564,"date":"2024-06-04T12:43:31","date_gmt":"2024-06-04T12:43:31","guid":{"rendered":"http:\/\/hnetalk.com\/provider\/?p=8564"},"modified":"2024-06-04T12:48:33","modified_gmt":"2024-06-04T12:48:33","slug":"formulary-june-2024","status":"publish","type":"post","link":"http:\/\/hnetalk.com\/provider\/formulary-june-2024\/","title":{"rendered":"Formulary Update (June 2024)"},"content":{"rendered":"

Health New England\u2019s formularies are located at healthnewengland.org<\/strong>. At the top of the page, use the \u201cFind A Drug\u201d tool.<\/p>\n

 <\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Brand Name<\/strong><\/td>\nGeneric Name<\/strong><\/td>\nGPI<\/strong><\/td>\nCommercial Formulary status<\/strong><\/td>\n<\/tr>\n
Aphexda MRX<\/td>\nMOTIXAFORTIDE ACETATE<\/td>\n82502050102150<\/td>\nPA thru Magellan, T4<\/td>\n<\/tr>\n
Daxxify MRX<\/td>\nDAXIBOTULINUMTOXINA-LANM<\/td>\n90890045402140<\/td>\nPA thru Magellan, T4<\/td>\n<\/tr>\n
Elrexfio MRX<\/td>\nELRANATAMAB-BCMM<\/td>\n213520281520**<\/td>\nPA thru Magellan, T4<\/td>\n<\/tr>\n
Eylea HD MRX<\/td>\nAFLIBERCEPT INTRAVITREAL<\/td>\n86655010002080<\/td>\nPA thru Magellan, T4<\/td>\n<\/tr>\n
FABHALTA\u00a0 CAP 200MG<\/td>\nIPTACOPAN HCL CAP 200 MG<\/td>\n85807535200130<\/td>\nPa thru Optum, T3, QL 60 capsules\/30 days<\/td>\n<\/tr>\n
Izervay MRX<\/td>\nAVACINCAPTAD PEGOL INTRAVITREAL<\/td>\n86456020102020<\/td>\nPA thru Magellan, T4<\/td>\n<\/tr>\n
Mounjaro<\/td>\nTIRZEPATIDE<\/td>\n2717308000D2**<\/td>\nPa thru Optum, T2, 4 pens per 28 days<\/td>\n<\/tr>\n
Pombiliti MRX<\/td>\nCIPAGLUCOSIDASE ALFA-ATGA<\/td>\n30907730052120<\/td>\nPA thru Magellan, T4<\/td>\n<\/tr>\n
Talvey MRX<\/td>\nTALQUETAMAB-TGVS<\/td>\n21352076802020<\/td>\nPA thru Magellan, T4<\/td>\n<\/tr>\n
Tofidence MRX<\/td>\nTOCILIZUMAB<\/td>\n<\/td>\nPA thru Magellan, T4<\/td>\n<\/tr>\n
Tyruko MRX<\/td>\nNATALIZUMAB<\/td>\n<\/td>\nPA thru Magellan, T4<\/td>\n<\/tr>\n
Veopoz MRX<\/td>\nPOZELIMAB-BBFG<\/td>\n85805070152020<\/td>\nPA thru Magellan, T4<\/td>\n<\/tr>\n
Vowst CAP<\/td>\nFECAL MICROBIOTA SPORES, LIVE-BRPK CAPS<\/td>\n52522020100120<\/td>\nNot Covered, formulary alternatives available<\/td>\n<\/tr>\n
Zoryve foam<\/td>\nROFLUMILAST FOAM 0.3%<\/td>\n90300045003920<\/td>\nPa thru Optum, T3, QL-60 grams\/30 days<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

If you have any questions about the information in this notice, please contact Health New England Provider Experience at (800) 842-4464, extension 5000. A representative is available Monday through Friday between the hours of 8:00 a.m. and 5:00 p.m. You may also send an email to providerrelations@hne.com<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Health New England\u2019s formularies are located at healthnewengland.org. At the top of the page, use the \u201cFind A Drug\u201d tool.   Brand Name Generic Name GPI Commercial Formulary status Aphexda MRX MOTIXAFORTIDE ACETATE 82502050102150 PA thru Magellan, T4 Daxxify MRX DAXIBOTULINUMTOXINA-LANM 90890045402140 PA thru Magellan, T4 Elrexfio MRX ELRANATAMAB-BCMM 213520281520** PA thru Magellan, T4 Eylea […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[1],"tags":[],"class_list":["post-8564","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-2e8","_links":{"self":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/8564","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=8564"}],"version-history":[{"count":3,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/8564\/revisions"}],"predecessor-version":[{"id":8571,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/8564\/revisions\/8571"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=8564"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=8564"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=8564"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}