Changes to covered medicines

Our Prescription Drug Listing, also called a formulary, 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 at horizonNJhealth.com/covered_drugs.

Here is a list of recent changes:
 

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)

Not Covered

Cipro HC (ciprofloxacin/hydrocortisone)

generic Ciprodex

Not Covered

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.