Changes to covered medicines
Our Prescription Drug Listing, also called aformulary,is changing. The most up-to-date listing, including information about which drugs require prior authorization (approval), step therapy, or have quantity/age limitations is posted online athorizonNJhealth.com/covered_drugs.
Here is a list of recent changes: Covered Change Description |
Brand (Generic) Drug Name |
Alternatives (if applicable) |
|---|---|---|
Covered |
Insulin Lispro Kwikpen 75/25 |
— |
Covered |
Focalin XR (dexmethylphenidate ER) |
— |
Covered |
Onfi (clobazam) tablets |
— |
Covered |
Otovel (ciprofloxacin/fluocinolone) |
— |
Covered |
Jelmyto (mitomycin) |
— |
Covered |
Koselugo (selumetinib) |
— |
Covered |
Tabrecta (capmatinib) |
— |
Covered |
Retevmo (selpercatinib) |
— |
Covered |
Rhinocort Allergy (budesonide) |
— |
Covered |
Lyrica Solution (pregabalin) |
— |
Covered |
Lunesta (eszopiclone) |
— |
Covered |
Ambien CR (zolpidem ER) |
— |
Covered |
Rapaflo (silodosin) |
— |
Covered |
Micardis (telmisartan) |
— |
Covered |
Tricor 48mg (fenofibrate) |
— |
Covered |
Avsola (infliximab-axxq) |
— |
Covered |
Evrysdi (risdiplam) |
— |
Covered |
Oriahnn (elagolix, estradiol, and norethindrone acetate) |
— |
Covered |
Enspryng (satralizumab-mwge) |
— |
Covered |
Dojolvi (triheptanoin) |
— |
不包括 |
Cipro HC (ciprofloxacin/hydrocortisone) |
generic Ciprodex |
不包括 |
Cortisporin (neomycin/polymixin/hydrocortisone) suspension |
generic Cortisporin solution |
Please talk with your PCP about these changes. If your PCP decides that, for medical reasons, you must take a medicine that is not on the formulary list or needs pre-approval, including a brand name medicine exception, he or she can call us and ask for special permission (prior authorization) for you to get the medicine. Please note that Horizon NJ Health’s maximum days’ supply limit is 30 days.