What types of drugs require a prior authorization review?

Phoenix Benefits is contracted directly with your plan sponsor to manage your prescription benefits program.  As part of this process we have a contractual obligation to administer the plan laid out by your plan sponsor.  Each plan sponsor may have different specifications for medications that require a prior authorization review.  Below is a list of the most common medications that typically require a review.

• High Cost Medications (Typically drugs over $1,500)
• Specialty Medications
• Opioid medications
• Drugs that treat ADHD if over a certain age
• Acne medications for members over a certain age
• Fertility medications (if covered)
• Weight Loss Medications (if covered)
• Medications that are injected