Covered medications—online drug formulary
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Fallon Health Formulary (pdf, last updated: 10/1/2024)
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Part B step therapy
In some cases, Fallon Health requires you to first try certain drugs to treat your medical condition before we'll cover another drug for that condition. For example, if Drug A and Drug B both treat your medical condition, your plan may not cover Drug B unless you try Drug A first. If Drug A doesn't work for you, your plan will then cover Drug B. Step Therapy may be required for the medications listed in the table below.
- Abraxane
- Aloxi/Palonestrom (avyxa)
- Asceniv/Alyglo/Yimmugo
- Avastin/Alymsys/Vegzelma/
Avzivi/Bendamustine
- Beovu
- Bortezomib
- Cimerli
- Durolane/Gel-One/GelSyn3/
GenVisc 850/Hyalgan/
Hymovis/Monovisc/
Orthovisc/sodium hyaluronate/
Supartz/Supartz FX/
Synojoynt
- Eylea/Eylea HD
- Fusilev/Khapzory
- Herceptin Hylecta
- Herceptin/Ontruzant/Herzuma/
Ogivri/Hercessi
- HP Acthar
- Lucentis/Byooviz
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- Macugen
- Neupogen
- Pemfexy
- Procrit/Epogen (non-ESRD)
- Prolia/Xgeva/Wgost/Jubbonti
- Remicade/Avsola/Renflexis/infliximab
- Releuko/Granix/Nivestym
- Rituxan Hyleca
- Rituxan/Riabni/Ruxience
- Rolvedon
- Ryzneuta
- Soliris/Bkemv
- Sustol
- Susvimo
- Treanda/Vivimusta
- Trivisc/VISCO-3/Triluron
- Udenyca/Ziextenzo/Nyvepria/ Stimufend/Fylnetra
- Ultomiris
- Vabysmo
- Zilretta
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H9001_250108_C | The information on this page was last updated on 10/1/2024.