Specialty Rx

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Overview of Specialty Drugs Supplied by Caremark

Caremark Specialty Pharmacy ensures convenient, express delivery and provides the supplies needed to administer the drug. Their health care professionals are available around the clock to provide telephone guidance and support. As an added convenience, most specialty medications can be picked up at CVS/Pharmacy locations.

To transfer a prescription to Caremark Specialty Pharmacy, call 1-800-237-2767.

Medical Condition

Medications

Allergic Asthma

Xolair*

Growth Hormone/Growth Hormone related drugs

Genotropin*
Humatrope*
Norditropin*
Nutropin/AQ*
Omnitrope*
Saizen*
Serostim*
Tev-Tropin*
Zorbtive*

Hematopoetic drugs
(which are being obtained from a pharmacy setting)

Aranesp**
Epogen**
Leukine
Neulasta**
Neumega**
Neupogen**
Procrit**

Hepatitis C

Copegus*
Incivek
Infergen*
Peg-Intron*
Pegasys*
Rebetol*
Rebetron*
Ribasphere*
ribavirin*
RibaTab*
Victrelis

HIV

Egrifta
Fuzeon

Infertility

Bravelle*
Cetrotide*
Follistim AQ*
Ganirelix*
Gonal-F*
HCG (Novarel, Pregnyl)*
Luveris*
Menopur*
Ovidrel*
Progesterone*
Repronex*

Inflammatory Bowel Disease

Cimzia
Humira
Tysabri

Multiple Sclerosis

Ampyra
Avonex*
Betaseron*
Copaxone*
Extavia
Gilenya*
Rebif*
Tysabri

Oral Oncology Drugs

Afinitor
Erivedge
Gleevec
Hycamtin
Inlyta
Jafafi
Nexavar*
Oforta
Revlimid*
Sprycel*
Sutent*
Tarceva
Targretin
Tasigna*
Temodar
Thalomid
Tykerb*
Votrient
Xalkori
Xeloda
Zelboraf
Zolinza*
Zytiga

Psoriasis

Amevive*
Enbrel*
Humira*
Stelara

Pulmonary Hypertension

Adcirca
epoprostenol sodium
Letairis
Remodulin
Revatio
Tracleer
Tyvaso
Ventavis

Respiratory drugs

Actimmune*
Pulmozyme
TOBI

Rheumatoid and Osteo Arthritis & Osteoporosis

Cimzia
Enbrel*
Forteo
Humira*
Kineret*
Orencia SQ
Simponi

Other

Aldurazyme
Arcalyst
Aralast
Cerezyme*
Fabrazyme
H.P. Acthar Gel*
Kuvan*
Leuprolide acetate
Lupron Depot
Sabril
Soliris
Thyrogen
Vpriv
Zoladex

Updated July 2012
(Please check back for updates.)

* These drugs (which require prior authorization and have clinical programs in place) must be obtained from Caremark Specialty Pharmacy Services in order to be covered for members.

** These drugs (which require prior authorization and have clinical programs in place) must be obtained from Caremark Specialty Pharmacy Services in order to be covered for members when the drug is to be obtained at the pharmacy setting.


A provision of the New York State 2013-2014 budget allows for the following changes to the pharmacy benefit for Managed Medicaid members:

Managed Medicaid/FHP members, or providers on behalf of members, may contact CDPHP and request to obtain specialty drugs at a retail pharmacy, rather than Caremark Specialty Pharmacy. CDPHP will facilitate the process by sending the appropriate paperwork to the network pharmacy. The network retail pharmacy must accept the price comparable to that of the specialty pharmacy, as well as sign a member/drug-specific contract amendment. Contract amendments refer only to price, not terms and conditions, and are not required for each refill. For further information, please call the CDPHP Pharmacy Department at (518) 641-3784.