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Pharmacy Prior Authorization
To determine if a Pharmacy prior authorication request is needed, the following steps should be taken.
Step 1: If the durg name is found in the Preferred Drug List, a prior authorization is not needed:
Preferred Drug List by Therapy Class
Step 2: Review the list of drugs that require authorization. If the drug is found in this, skip to step 4 to request authorization:
Drugs That Require Authorization
Step 3: If there is an acceptable substitution drug available, a prior authorization is not needed:
epocrates.com website
Step 4: If the drug is not in steps 1 and 3 above, or it is noted as requiring authorization in step 2, a prior authorization is needed:
Prior Authorization Request for a Non-Preferred Drug
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