Most Frequently Prescribed Medications

Most Frequently
Prescribed
Medications†
Aetna Specialty Pharmacy®
A specialty pharmacy is a provider of specialty
medications to treat certain chronic diseases, like
multiple sclerosis, hemophilia and immune system
disorders. Specialty medications can be injected,
infused, or taken by mouth. These medications may
need to be refrigerated. They are often expensive
and may not be available at retail pharmacies. Some
may have side effects, so a pharmacist or nurse should
monitor their use.
Aetna Specialty Pharmacy offers high-touch, therapyspecific support services to its members during their
treatment with specialty medications. Aetna Specialty
Pharmacy also provides compounding services to
prepare customized medication to meet individual
member needs.
P rod uct Name
S C I E N T I F I C Name
naltrexone
ASTHMA
Xolair
omalizumab
ANEMIA/CHRONIC RENAL FAILURE
Aranesp
Epogen
Procrit*
COMPOUNDED PRODUCTS
Capsules
Creams
Hydroxyprogesterone injectables
Intrathecal sterile compounds
Pediatric suspensions
Progesterone capsules/suppositories/injectables
Tablets
CROHN’S DISEASE
Humira
Remicade
adalimumab
infliximab
ENZYME REPLACEMENT
Aldurazyme
Cerezyme
Fabrazyme
Myozyme
darbepoetin alfa
epoetin alfa
epoetin alfa
Genotropin
Humatrope* PR SI
Lupron Pediatric Norditropin PR­­­­­­
Nutropin PR SI
Nutropin AQ PR SI
Omnitrope PR
Saizen Serostim Tev-Tropin PR SI
laronidase
imiglucerase
agalsidase beta
alglucosidase alfa
*Indicates medications that can be filled through our
Ready-To-Inject, pre-filled syringe dosing program.
†
This document is a sample list of medications that are available
through Aetna Specialty Pharmacy. This list is subject to change.
If
you have questions or need more information, please call
1-866-782-ASRX (1-866-782-2779).
somatropin
somatropin
leuprolide acetate for depot suspension
somatropin
somatropin
somatropin
somatropin
somatropin
somatropin
somatropin
Gynecology
Delestrogen
Depo Provera
Lupron
05.03.350.1 (3/08)
SCIENTIFIC N ame
GROWTH HORMONE/endocrinology
ALCOHOLISM
Vivitrol
Prod uct N ame
estradiol valerate injection, USP
medroxyprogesterone acetate
leuprolide acetate
P rod uct Name
S C I E N T I F I C N ame
Prod uct N ame
HEMATOLOGY / CARDIOLOGY
INFERTILITY
Arixtra SI
Fragmin SI
Heparin
Innohep* SI
Lovenox* SI
Bravelle PR SI
Cetrotide PR
Clomid
Follistim PR SI
Follistim AQ PR SI
Ganirelix PR SI
Gonal-F PR HCG PR SI
Lupron Depot 2-week kitSI
Menopur
Novarel PR SI
Ovidrel PR SI
Progesterone
Repronex PR SI
fondaparinux
dalteparin sodium
heparin sodium
tinzaparin sodium
enoxaparin sodium
HEMOPHILIA
Advate PR SI
antihemophilic factor VIII (recombinant)
plasma/albumin free
Alphanate PR SI
antihemophilic factor VIII (human)
AlphaNine SD PR SI
coagulation factor IX
Amicar
aminocaproic acid
BeneFIX PR SI
coagulation factor IX (recombinant)
FEIBA VH IMMUNO PR
anti-inhibitor coagulant complex
Helixate FS PR SI
antihemophilic factor VIII (recombinate)
PR
SI
Hemofil M
antihemophilic factor VIII (human)
Humate P PR SI
antihemophilic factor/von Willebrand
Factor complex (human)
Kogenate FS PR SI
antihemophilic factor VIII (recombinate)
Monarc M PR SI
antihemophilic factor VIII (human)
Monoclate P PR SI
antihemophilic factor VIII (human)
Mononine PR
coagulation Factor IX
NovoSeven PR
coagulation Factor VIIa (recombinant)
PR
Recombinate antihemophilic factor VIII (recombinate)
Refacto PR
antihemophilic factor VIII (recombinate)
Stimate
desmopressin acetate
HEPATITIS
hepatitis B immune globulin
ribavirin tablets
adefovir dipivoxil
interferon alfacon-1
hepatitis B immune globulin
peginterferon alfa 2b
peginterferon alfa 2a
ribavirin capsules and tablets
BayHep B
Copegus
Hepsera
Infergen PR SI
Nabi-HB
Peg-Intron* PR SI
Pegasys* PR SI
Ribavirin
HIV & AIDS
lamivudine/zidovudine
emtricitabine
lamivudine, 3TC
abacavir + lamivudine
enfuvirtide
etravirine
saquinavir
lopinavir/ritonavir
fosamprenavir
ritonavir
atazanavir
somatropin
efavirenz
abacavir + zidovudine + lamivudine
tenofovir + emtricitabine
nelfinavir mesylate
nevirapine
tenofovir
Combivir
Emtriva
Epivir
Epzicom
Fuzeon SI
Intelence
Invirase
Kaletra
Lexiva
Norvir
Reyataz
Serostim
Sustiva
Trizivir
Truvada
Viracept
Viramune
Viread
IMMUNE SYSTEM / IVIG
BayRho-D
Carimune NF PR
CellCept
CytoGam
Flebogamma
Gamastan
Gammagard S/D
Gamunex PR
Octagam
Pentamidine
Prograf
Rapamune
RhoGam
Vivaglobin
PR
Rho (D) immune globulin
immune globulin intraveous
mycophenolate mofetil
cytomegalovirus immune globulin
immune globulin intraveous
immune globulin-intramuscular
immune globulin intraveous
immune globulin intraveous
immune globulin intraveous
pentamidine isethionate
tacrolimus
sirolimus
Rho (D) immune globulin
immune globulin subcutaneous
SCIENTIFIC N ame
urofollitropin
cetrorelix
clomiphene citrate
follitropin beta
follitropin beta
ganirelix acetate
follitropin alfa
human chorionic gonadotropin
leuprolide acetate
menotropins for injection, USP
chorionic gonadotropin
choriogonadotropin alfa
progesterone
menotropins
MACULAR DEGENERATION
Avastin
Lucentis
Macugen
bevacizumab
ranibizumab
pegaptanib sodium
NEUROLOGY/MULTIPLE SCLEROSIS
Avonex* SI
Betaseron SI
Botox
Copaxone SI
Myobloc
Rebif SI
Tysabri
interferon beta-1a
interferon beta-1b
botulinum toxin type A
glatiramer acetate
botulinum toxin type B
interferon beta-1a
natalizumab
ONCOLOGY
Adriamycin
Alferon N SI
Aredia
Arimidex
Avastin BCG Live
BiCNU
Bleomycin
Camptosar
CeeNU
Cisplatin
Cosmegen
Cytarabine
Cytoxan
Dacarbazine
Daunorubicin
Doxil
Doxorubicin
Eligard
Elitek
Ellence
Eloxatin
Emcyt
Erbitux
Ethyol
Etopophos
Etoposide
Eulexin
Faslodex
Fludara
Fluorouracil
Gemzar
Gleevec PR
Herceptin
Hycamtin
Ifex/Mesnex
Intron A PR SI
Iressa PR
Leucovorin
Leukeran
Leukine*
Leuprolide
Lupron
Matulane
doxorubicin HCL
interferon alpha-N3
pamidronate disodium (adjunct)
anastrozole
bevacizumab
bacillus calmette guerin
carmustine
bleomycin sulfate
irinotecan
lomustine
cisplatin
dactinomycin
cytarabine
cyclophosphamide
dacarbazine
daunorubicin
doxorubicin liposomal
doxorubicin
leuprolide acetate
rasburicase
epirubicin
oxaliplatin
estramustine phosphate sodium
cetuximab
amifostine
etoposide
etoposide
flutamide
fulvestrant
fludarabine phosphate
fluorouracil
gemcitabine HCL
imatinib mesylate
trastuzumab
topotecan
ifosfamide/mesna
interferon alfa 2b
gefitinib
leucovorin calcium
chlorambucil
sargramostim
leuprolide acetate
leuprolide acetate
procarbazine
P rod uct Name
S C I E N T I F I C Name
Prod uct N ame
Mesnex
Methotrexate
Mitomycin
Mustargen
Mutamycin
Navelbine
Nexavar
Novantrone
Paclitaxel
Paraplatin
Plenaxis
Proleukin*
Revlimid
Rituxan
Roferon-A* PR SI
Sprycel
Sutent
Tarceva
Tasigna Taxol
Taxotere
Temodar
Thalomid
Tykerb Vantas Vectibix
Velcade
Vinblastine
Vincristine
Xeloda
Zoladex
mesna
methotrexate
mitomycin
mechlorethamine HCL
mitomycin
vinorelbine
sorafenib
mitoxantrone
paclitaxel
carboplatin
abarelix
aldesleukin
lenalidomid
rituximab
interferon alfa-2a
dasatinib
sunitinib malate
erlotinib
nilotinib
paclitaxel
docetaxel
temozolomide
thalidomide
lapatinib
histerlin
panitumumab
bortezomib
vinblastine sulfate
vincristine sulfate
capecitabine
goserelin acetate
PARKINSON’S DISEASE
ONCOLOGY ADJUNCT
Anzemet QL
Aloxi
Compazine
Emend
Epogen
Kytril QL
Neulasta
Neumega
Neupogen*
Procrit*
Sandostatin*
Zofran QL
Zometa
dolasetron mesylate
palonosetron
prochlorperazine
aprepitant
epoetin alfa
granisetron HCL
pegfilgrastim
oprelvekin
filgrastim
epoetin alfa
octreotide acetate
ondansetron HCL
zoledronic acid
SCIENTIFIC N ame
apomorphine
Apokyn
POMPE DISEASE
Myozyme
alglucosidase alfa
PSORIASIS/psoriatic arthritis
Amevive
Enbrel SI
Raptiva SI
Remicade
alefacept
etanercept
efalizumab
infliximab recombinant
PULMONARY
Actimmune
Coly-Mycin M
Letairis
Pulmozyme
Revatio
Tobi
Tracleer
interferon gamma-1b
colistimethate sodium
ambrisentan
dornase alfa
sildenafil
tobramycin
bosentan
RESPIRATORY SYNCYTIAL VIRUS (RSV)
Synagis
PR
palivizumab
UROLOGY
Delatestryl
Depo Testosterone
testosterone enanthate injection
testosterone cyplonate injection USP
Transplant
CellCept
Gengraf
Imuran
Neoral
Prograf
Rapamune
Sandimmune
Prednisone
mycophenolate
cyclosporine
azathioprine
cyclosporine
tacrolimus
sirolimus
cyclosporine
prednisone­­­
OSTEOARTHRITIS & RHEUMATOID ARTHRITIS
Enbrel SI
Euflexxa
Humira SI
Hyalgan
Kineret SI
Methotrexate
Orencia
Orthovisc
Remicade
Supartz
Synvisc
etanercept
highly purified hyaluronan
adalimumab
sodium hyaluronate
anakinra
methotrexate
abatacept
hyaluronate acid
infliximab recombinant
sodium hyaluronate
hylan G-F 20
OSTEOPOROSIS
Forteo SI
Boniva
teriparatide
ibandronate
OTHER
Acthar Gel
adrenocorticotropic hormone (ACTH)
PAIN MANAGEMENT
Buprenex
Ketorolac
Lioresal
Marcaine
Nalbuphine
Nubain
Prialt buprenorphine­­
ketorlac tromethamine
baclofen
bupivacaine
nalbuphine
nalbuphine
ziconotide intrathecal
Key
PR = Precertification required under most plans
QL = Quantity Limits applies under most plans
SI = Self-injectable drug (some plans may cover injectable
medications through the medical benefit)
Aetna Specialty Pharmacy refers to Aetna Specialty Pharmacy, LLC, a subsidiary of Aetna Inc.,
which is a licensed pharmacy that operates through specialty pharmacy prescription fulfillment.
The charges Aetna negotiates with Aetna Specialty Pharmacy may be higher than the cost it pays
for the drugs and the costs of its specialty pharmacy services. For these purposes, Aetna Specialty
Pharmacy’s cost of purchasing drugs takes into account discounts, credits and other amounts it may
receive from wholesalers, manufacturers, suppliers, and distributors.
Aetna is the brand name used for products and services provided by one or more of the
Aetna group of subsidiary companies. The Aetna companies that offer, underwrite or
administer benefits coverage include Aetna Health Inc., Aetna Health of California Inc.,
Aetna Health of the Carolinas Inc., Aetna Health of Illinois Inc., Aetna Health Insurance
Company of New York, Aetna Health Insurance Company and/or Aetna Life Insurance
Company (Aetna).
©2008 Aetna Inc.
05.03.350.1 (3/08)