Products added:

• Edurant
• Flumist*
• Halaven
• Influenza vaccine*
• Phoslyra
• Rilutek
• Sylatron**
• Zytiga**

Products now requiring prior authorization:

• Incivek**
• Kapvay
• Nexiclon XR
• Peg-Intron**
• Topicort LP ointment
• Victrelis**

Products now requiring step care:

• Avalide
• Avapro

Products no longer requiring prior authorization:

• Lipitor 40 mg and 80 mg
• Opium tincture
• Pantoprazole tablets

Products removed:

• Ortho Tri-Cyclen Lo
• Pegasys

Products with quantity limit changed:

• Tamiflu suspension — 180 ml per prescription, two prescriptions per member per calendar year

*For Network Health patients at least 18 years of age, when administered by a pharmacist between September 15, 2011 and March 31, 2012, at a participating pharmacy
** Provided through Caremark

We update our Preferred Drug List quarterly. Download our Preferred Drug List and pharmacy prior authorization form.