Most patients who developed these infections were taking concomitant That may lead to hospitalization or death. Patients treated with ENBREL are at increased risk for developing serious infections IMPORTANT SAFETY INFORMATION AND INDICATIONS Please call the number on the back of your member ID card for assistance.Prescription Enbrel ® (etanercept) is administered by injection. To assist in the management of select specialty medications, some pharmacy benefit designs require the use of a preferred specialty pharmacy. Click the Quantity Limit icon next to the drug name for more details. Limits the amount of drug that a beneficiary may receive in a certain period. Medications may beĪvailable to some members at no cost with a prescription.Ĭoverage of this drug is subject to review by the plan and is based on Pharmacy policy. Medication: May be available with a copay exception. ![]() Please click icon next to medication for further details. ![]() So the member may only be responsible for a copay/coinsurance, if applicable. Authorized generic medications may take a brand cost-share.ĭrugs on this list will be covered as if the deductible has already been met, Generic or Authorized Generic Medication. Products available as prepackaged products that supply a day supply greater Limited to a 30, 31, or 34 day supply at retail and/or mail pharmacies. Contact Member Services for more information.ĭepending on member benefits, this medication may be This medication may not be covered under your Plan. Coverage is not provided for Prescription Drugs and Over-the-Counter Drugs not appearing on the Formulary drug list, unless an exception has been granted by the Plan pursuant to the Step Therapy Program. Non-Formulary drugs are not on the Formulary drug list. Unless an exception has been granted by the Plan pursuant to the Step Therapy Coverage is not provided for Prescriptionĭrugs and Over-the-Counter Drugs not appearing on the Formulary drug list, Includes brand and generic drugs and specialty medications.Īre not on the Formulary drug list. Tier 3 includes standard brands and some generic drugs.Ĥ Generic and Brand Drugs: typically have the highest member cost share. Tier 2 is still mostly generic drugs with only very select categories ofģ Generic and Brand Drugs: typically have a higher member cost share than lower Reditrex (Pf) Subcutaneous Syringe 7.5 Mg/0.3 Mlġ Generic Drugs: typically have the lowest member cost share.Ģ Generic and Brand Drugs: typically have a higher member cost share than Tierġ. Reditrex (Pf) Subcutaneous Syringe 25 Mg/Ml Reditrex (Pf) Subcutaneous Syringe 22.5 Mg/0.9 Ml Reditrex (Pf) Subcutaneous Syringe 20 Mg/0.8 Ml Reditrex (Pf) Subcutaneous Syringe 17.5 Mg/0.7 Ml Reditrex (Pf) Subcutaneous Syringe 15 Mg/0.6 Ml Reditrex (Pf) Subcutaneous Syringe 12.5 Mg/0.5 Ml Reditrex (Pf) Subcutaneous Syringe 10 Mg/0.4 Ml Rasuvo (Pf) Subcutaneous Auto-Injector 7.5 Mg/0.15 Ml Rasuvo (Pf) Subcutaneous Auto-Injector 30 Mg/0.6 Ml Rasuvo (Pf) Subcutaneous Auto-Injector 25 Mg/0.5 Ml Rasuvo (Pf) Subcutaneous Auto-Injector 22.5 Mg/0.45 Ml Rasuvo (Pf) Subcutaneous Auto-Injector 20 Mg/0.4 Ml Rasuvo (Pf) Subcutaneous Auto-Injector 17.5 Mg/0.35 Ml Rasuvo (Pf) Subcutaneous Auto-Injector 15 Mg/0.3 Ml Rasuvo (Pf) Subcutaneous Auto-Injector 12.5 Mg/0.25 Ml ![]() Rasuvo (Pf) Subcutaneous Auto-Injector 10 Mg/0.2 Ml Otrexup (Pf) Subcutaneous Auto-Injector 25 Mg/0.4 Ml Otrexup (Pf) Subcutaneous Auto-Injector 22.5 Mg/0.4 Ml Otrexup (Pf) Subcutaneous Auto-Injector 20 Mg/0.4 Ml Otrexup (Pf) Subcutaneous Auto-Injector 17.5 Mg/0.4 Ml Otrexup (Pf) Subcutaneous Auto-Injector 15 Mg/0.4 Ml Otrexup (Pf) Subcutaneous Auto-Injector 12.5 Mg/0.4 Ml Otrexup (Pf) Subcutaneous Auto-Injector 10 Mg/0.4 Ml Analgesic, Anti-Inflammatory Or Antipyretic
0 Comments
Leave a Reply. |