Drugs Requiring Prior Authorization by the 1199SEIU Benefit Fund

Call the Benefit Fund at (646) 473-7446.

Effective June 2019. Subject to change.

Brand Name Therapeutic Category
ADVATE ANTIHEMOPHILIC FACTORS
ADYNOVATE ANTIHEMOPHILIC FACTORS
AFSTYLA ANTIHEMOPHILIC FACTORS
ALDURAZYME METABOLIC DX ENZYME REPLACE, MUCOPOLYSACCHARIDOSIS
ALPHANATE ANTIHEMOPHILIC FACTORS
ALPHANINE SD FACTOR IX PREPARATIONS
ALPROLIX FACTOR IX PREPARATIONS
BENEFIX FACTOR IX PREPARATIONS
CEREZYME METABOLIC DISEASE ENZYME REPLACEMENT, GAUCHER'S DX
CORIFACT FACTOR XIII PREPARATIONS
CYTOGAMIMMUNE GLOBULIN - CMV
ELAPRASE METABOLIC DX ENZYME REPLACE, MUCOPOLYSACCHARIDOSIS
ELELYSOMETABOLIC DISEASE ENZYME REPLACEMENT, GAUCHER'S DX
ELOCTATE ANTIHEMOPHILIC FACTORS
FABRAZYME METABOLIC DISEASE ENZYME REPLACEMENT, FABRY'S DX
FEIBA NF ANTIHEMOPHILIC FACTORS
HELIXATE FS ANTIHEMOPHILIC FACTORS
HEMOFIL M ANTIHEMOPHILIC FACTORS
HUMATE-P ANTIHEMOPHILIC FACTORS
IDELVION FACTOR IX PREPARATIONS
IXINITY FACTOR IX PREPARATIONS
JIVI ANTIHEMOPHILIC FACTORS
KOATE ANTIHEMOPHILIC FACTORS
KOGENATE FS ANTIHEMOPHILIC FACTORS
KOVALTRY ANTIHEMOPHILIC FACTORS
LINEZOLID-0.9% NACL OXAZOLIDINONE ANTIBIOTICS
LINEZOLID-D5W OXAZOLIDINONE ANTIBIOTICS
LUMIZYME METABOLIC DISEASE ENZYME REPLACEMENT, POMPE DISEASE
MIGLUSTAT DRUGS TO TX GAUCHER DX-TYPE 1, SUBSTRATE REDUCING
MONOCLATE-P ANTIHEMOPHILIC FACTORS
MONONINE FACTOR IX PREPARATIONS
NAGLAZYME METABOLIC DX ENZYME REPLACE, MUCOPOLYSACCHARIDOSIS
NOVOEIGHT ANTIHEMOPHILIC FACTORS
NOVOSEVEN RT ANTIHEMOPHILIC FACTORS
NUWIQ ANTIHEMOPHILIC FACTORS
OBIZUR ANTIHEMOPHILIC FACTORS
PANZYGA ANTISERA
PROFILNINE FACTOR IX COMPLEX (PCC) PREPARATIONS
REBINYN FACTOR IX PREPARATIONS
RECOMBINATE ANTIHEMOPHILIC FACTORS
RIXUBIS FACTOR IX PREPARATIONS
TRETTEN FACTOR XIII PREPARATIONS
VIMIZIM METABOLIC DX ENZYME REPLACE, MUCOPOLYSACCHARIDOSIS
VPRIV METABOLIC DISEASE ENZYME REPLACEMENT, GAUCHER'S DX
WILATE ANTIHEMOPHILIC FACTORS
XYNTHA ANTIHEMOPHILIC FACTORS
XYNTHA SOLOFUSE ANTIHEMOPHILIC FACTORS
ZAVESCA DRUGS TO TX GAUCHER DX-TYPE 1, SUBSTRATE REDUCING
ZYVOX PIGGYBACK OXAZOLIDINONE ANTIBIOTICS
English
Español English