Our drug list and prescribing guidelines is a tool for the management of the quality and cost of drug therapy. The scope of these guidelines is limited to ambulatory drugs. Those concerned with the prescribing, dispensing and reimbursement of medicines may refer to this service in choosing quality, cost-effective treatment.
Our prescribing guidelines are different from hospital guidelines in that they do not include dosage forms and actual drug costs. (Actual costs change frequently and therefore do not remain accurate over time.) Instead, prescribing guidelines list the relative cost of therapy.
Coverage for specific medications will depend on the member's benefits program. Members should read their certificate of coverage or benefits booklet for further details on their plan. Please call the number on the member's ID card for further assistance or clarification on your patient's benefits, including the appropriate prescription drug list.
Review the current commercial drug lists on the member website.
Commonly Prescribed Formulary Medications List
Members are normally required to use a contracted, participating pharmacy in our pharmacy network to best maximize their benefits. Be sure to ask your patient for their preferred pharmacy choice before e-prescribing the prescription. For some medications, members may need to use a home delivery or specialty and complex care pharmacy.
Mail Service for Commercial (HMO and non-HMO): ePrescribe new prescriptions to Express Scripts® Pharmacy (Home Delivery) or call 888-327-9791 for faxing instructions. You can also call the pharmacy at 833-715-0942 (for Commercial) or 833-599-0731 (for Medicaid).
Mail Service for Commercial, HMO Only: ePrescribe new prescriptions to Walgreens Mail Service or use the fax order form. You can also call the pharmacy at 877-357-7463.
Refer to the Specialty and Complex Care Pharmacy Program section for more information on where to send prescriptions for specialty and complex care medications.
Refer to the Medicaid section for mail service and other forms.