To request a drug prior authorization (PA), contact the Minnesota Health Care Programs Prescription Drug PA Agent at 866-205-2818 (phone) or 866-648-4574 (fax).
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | X | Y | Z
Abilify MyCite
Abiraterone
Actemra
Acthar Gel
Actiq-Abstral-Fentora-Lazanda-Onsolis-Subsys
Adakveo
Adcetris
Aduhelm
Akynzeo
Alecensa
Aliqopa
Alunbrig
Amondys 45
Ampyra
Amrix
Annovera
Anti-Obesity Medications
Aptiom
Arcapta
Arikayce
Aristada
Austedo
Ayvakit
Azasite
Balversa
Banzel
Bavencio
Baxdela
Benlysta
Beovu
Besponsa
Bevyxxa
Biosimilars
Blenrep
Bosulif
Botulinum Toxins
Braftovi
Brand Preferred Over Generic
Branded Drugs - DAW
Brexafemme
Brineura
Briviact
Bryhali
Bylvay
Cabometyx
Calquence
Capital and Codeine
Caplyta
Caprelsa
Carisoprodol
CGRP Antagonists
Cholbam
Cimzia
Cinqair
Cometriq
Copiktra
Corlanor
Cotellic
Crysvita
Cystaran
Darzalex
Dayvigo
Desoxyn
Diabetic testing supplies
Diacomit
Dojolvi
Doptelet
Doxylamine-Pyridoxine Fixed Dose Combinations
Drugs with new or expanded indications
Duavee
Dupixent
Durysta
Egaten
Egrifta
Elevidys
Elzonris
Emflaza
Empliciti
Endari
Enhertu
Enjaymo
Enspryng
Epaned
Epidiolex
Erivedge
Erleada
Erwinaze
Eucrisa
Evekeo
Evenity
Exkivity
Evrysdi
Exondys 51
Eylea
Farydak
Fasenra
Fenofibrates
Ferriprox
Fexmid
Fintepla
Fleqsuvy
Fyarro
Fycompa
Galafold
Gattex
Giazo
Gilotrif
Givlaari
GLP-1 receptor agonists
GnRH agonists for pubertal suppression
Gocovri
Gralise
Grandfathering Definition and Criteria
Grastek
Growth Hormone
Hemangeol
Hepatitis C (effective through 2/28/2023)
Hepatitis C (effective beginning 3/1/2023)
Hereditary Angioedema
Hetlioz and Hetlioz LQ
Hospital discharge transition fill
Ibrance
Ibsrela
Iclusig
Idhifa
Ilaris
Imbruvica
Imlygic
Immunomodulators
Ingrezza
Inlyta
Inqovi
Inrebic
Intuniv
Invega
Iressa
Kalydeco
Kanuma
Kapvay
Kerendia
Keveyis
Keytruda
Kimmtrak
Kineret
Kisqali
Korlym
Krintafel
Lartruvo
Lemtrada
Lenvima
Libtayo
Lidoderm
Livmarli
Livtencity
Lokelma
Lonsurf
Lorbrena
Lotronex
Lucemyra
Lucentis
Lumoxiti
Lutathera
Luxturna
Lynparza
Macrilen
Marinol
Mavenclad
Mayzent
Medication Therapy Management
Mekinist
Mektovi
Mepsevii
Monjuvi
Motegrity
Movantik
Mozobil
Mulpleta
Myalept
Naloxone
Nascobal
Nerlynx
New drugs and new or nonpreferred dosage forms
Nexviazyme
Ninlaro
Nitisinone
Novarel
Nubeqa
Nucala
Nucynta
Nuedexta
Nulojix
Nuplazid
Nursing home transition fill
Nurtec ODT
Nuzyra
Ocaliva
Ocrevus
Odomzo
Oleptro
Omeclamox-Pac
Ongentys
Onmel
Onpattro
Opdivo
Opdualag
Ophthalmic Antihistamines
Opiate Combinations
Opioids Long Acting Pain Management Plan
Oracea
Oralair
Oriahnn
Orilissa
Orkambi
Otrexup
Oxbryta
Padcev
Palforzia
Palynziq
Parsabiv
PCSK9 Inhibitors
Pemazyre
Pemfexy
Phentolamine
Phesgo
Piqray
Polivy
Pomalyst
Potiga
Probuphine
Prolia
Provigil, Nuvigil
Pyrukynd
Radicava
Ragwitek
Rasuvo
Rayaldee
Recorlev
Rectiv
Relistor
Retevmo
Retroactive eligibility
Revatio, Adcirca
Revcovi
Reyvow
Rexulti
Rozlytrek
Rubraca
Rydapt
Rylaze
Ryplazim
Samsca
Saphnelo
Sarclisa
Scemblix
Secuado
Seroquel XR (regimen review)
Siklos
Silenor
Sinuva
Sirturo
Soliris
Solosec
Soolantra
Spinraza
Spravato
Stivarga
Strensiq
Sublocade
Sunosi
Susvimo
Symdeko
Symproic
Synagis - MN policy 2024-2025 season
Tabrecta
Tagrisso
Talzenna
Tarpeyo
Tecentriq
Tepezza
Testosterone
Tezspire
Tibsovo
Tivdak
Trikafta
Triptan quantity limits
Trodelvy
Trogarzo
Trokendi XR
Truseltiq
Tukysa
Tyrvaya
Tysabri
Ubrelvy
Ultomiris
Ultram ER, Ryzolt ER, ConZip
Uptravi
Vabysmo
Veltassa
Venclexta
Verzenio
Viberzi
Vijoice
Viltepso
Vimizim
Vimpat
Vitrakvi
Vizimpro
Vonjo
Voxzogo
Vraylar
Vuity
Vumerity
Vyepti
Vyndaqel & Vyndamax
Vyondys 53
Vyvgart
Xalkori
Xcopri
Xenazine
Xenical
Xenleta
Xermelo
Xgeva
Xifaxan
Xofluza
Xolair
Xpovio
Xtandi
Xyrem
Xywav
Zanaflex
Zejula
Zelboraf
Zeposia
Zepzelca
Ziana
Zinplava
Zolgensma
Zyclara
Zydelig
Zykadia
Zyprexa Relprevv
