Drugs Prior Authorized by Medco

Acne (Tazorac)
Acne (Tretinoin)
Acthar gel
Afinitor
Alzheimer's therapy
Amevive
Anemia
Apokyn (effective July 6, 2010)
Arcalyst
Avastin
Berinert (effective July 6, 2010)
Botox/Myobloc
Caverject
Cinryze (effective July 6, 2010)
CNS stimulants (age 19 years and older)
Dacogen (effective July 6, 2010)
Edex
Erbitux
Flolan / Tracleer
Gleevac
Herceptin (effective July 6, 2010)
Ilaris (effective July 6, 2010)
Immunoglobulins (IVIG)
Interferons
Iressa
Isotretinoin (Accutane, Sotret)
Kalbitor (effective July 6, 2010)
Kuvan
Lidoderm Patch
Misc. Ophthalmic Agents - Restasis
Misc. RA Agents + Remicade + Rituxan
Multiple Sclerosis Therapy (Avonex)
Multiple Sclerosis Therapy (Avonex/Rebif)
Multiple Sclerosis Therapy (Betaseron)
Multiple Sclerosis Therapy (Copaxone)
Multiple Sclerosis Therapy (Tysabri)
Muse
Myeloid Stimulants
Nexavar
PDST-Growth Hormone
PDST-PPI Rule (non-preferred PPI's)
Penlac
PPI "Custom" Rule for use beyond 90-days
Provigil / Nuvigil
Regranex
Sensipar
Soliris
Sprycel
Stelara (effective July 6, 2010)
Sutent
Synagis
Tarceva
Tasigna (effective July 6, 2010)
Temodar
Testosterone + Androgen Agents
Thalomid & Revlimid
Torisel
Tykerb
Vidaza (effective July 6, 2010)
Vectibix
Votrient (effective July 6, 2010)
Weight-loss Agents
Xenazine (effective July 6, 2010)
Xolair
Zolinza