When to Get Prior Approval for a Prescription
Certain medications must be approved for coverage before
you fill a prescription. These medications include:
- Alglucerase (treatment for liver, spleen and bone
marrow conditions);
- Erythropoetin (used to treat anemia associated with
HIV or its treatments);
- Filgrastim (helps the body make white blood cells to
prevent infections);
- GM-CSF (used to treat non-Hodgkin’s lymphomas
and leukemia);
- Growth hormones; and
- Octreotide (used on growth hormones, certain tumors
and gastrointestinal problems).
To get approval for any of the above medications, your
doctor or provider should call the Caremark® Pharmacy
Benefit Manager at the toll-free number shown on the
Resources chart in the Administration Information section
of this SPD.
