The following medications require prior authorization

Brand Name
8-MOP
Accutane
Actimmune
Alferon N
Ambiem CR
Amevive
Aranesp
Avinza
Avonex
Betaseron
Copaxone
Eligard
Enbrel
Epogen
Forteo
Genotropin
Humatrope
Humira
Infergen
Intron A
Iplex
Iressa
Kineret
Leukine
Lunesta
Lupron/Lupron Depot/Lupron Depot-Ped
Neulasta
Neumega
Neupogen
Norditropin
Nutropin/Nutropin AQ/Nutropin Depot
Oxsoralen-Ultra
Pegasys
Peg-Intron
Procrit
Protropin
Prozac Weekly
Raptiva
Rebetron
Rebif
Regranex
Remicade
Roferon
Rozerem
Saizen
Serostim
Somavert
Soriatane / Soriatane CK
Sotret
Synagis
Synarel
Tev-Tropin
Xanax XR
Xolair
Zorbtive

Generic Name
methoxsalen
isotretinoin
interferon gamma 1B
interferon alpha N3
zolpidem extended release
alefacept
darbepoetin
morphine sulfate extended release
interferon beta 1a
interferon beta 1B
glatiramer acetate
leuprolide acetate
etanercept
epoetin alfa
teriparatide
somatropin
somatropin
adalimumab
interferon alfacon-1
interferon alfa 2B
mecasermin rinfabate
gefitinib
anakinra
sargramostin
eszopiclone
leuprolide acetate
pegfilgrastim
oprelvekin
filgrastim
somatropin
somatropin
methoxalen rapid
peg-interferon alfa 2a
peg-interferon alfa 2b
epoetin alfa
somatrem
fluoxetine (weekly)
eflazumab
interferon alfa -2b/ribavirin
interferon beta 1A
becaplermin
infliximab
interferon alpha
ramelteon
somatropin
somatropin
pegvisomant
acitretin
isotretinoin
pavlivizumab
nafarelin
somatropin
alprazolam
omalizumab
somatropin