Colorado Medicaid January 7, 2020 Meeting

MANUFACTURER BRAND NAME THERAPEUTIC CLASS ABBVIE US LLC DUOPA (MISCELL) ANTIPARKINSON'S AGENTS ABBVIE US LLC NIASPAN (ORAL) LIPOTROPICS, OTHER ABBVIE US LLC TRICOR (ORAL) LIPOTROPICS, OTHER ABBVIE US LLC TRILIPIX (ORAL) LIPOTROPICS, OTHER ACADIA PHARMACE NUPLAZID CAPSULE (ORAL) ANTIPSYCHOTICS ACADIA PHARMACE NUPLAZID TABLET (ORAL) ANTIPSYCHOTICS ACORDA THERAPEU AMPYRA (ORAL) MULTIPLE SCLEROSIS AGENTS ACORDA THERAPEU INBRIJA (INHALATION) ANTIPARKINSON'S AGENTS U.S. BR NAMENDA XR (ORAL) ALZHEIMER'S AGENTS ACTAVIS U.S. BR SAPHRIS (SUBLINGUAL) ANTIPSYCHOTICS ACTAVIS U.S. BR VRAYLAR (ORAL) ANTIPSYCHOTICS ADAMAS PHARMA, GOCOVRI (ORAL) ANTIPARKINSON'S AGENTS AERIE PHARMACEU RHOPRESSA (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS AERIE PHARMACEU ROCKLATAN (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS AKORN INC. COSOPT PF (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS AKORN INC. ZIOPTAN (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALCON (P.R.) MAXIDEX (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALCON LABS. ALOMIDE (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALCON LABS. AZOPT (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALCON LABS. BETOPTIC S (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALCON LABS. DUREZOL (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALCON LABS. FLAREX (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALCON LABS. ILEVRO (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALCON LABS. NEVANAC (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALCON LABS. PATADAY (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALCON LABS. PATANASE (NASAL) INTRANASAL RHINITIS AGENTS ALCON LABS. PAZEO (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALCON LABS. SIMBRINZA (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALCON LABS. TRAVATAN Z 2.5 ML (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALCON LABS. TRAVATAN Z 5 ML (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS INC. ACUVAIL (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALLERGAN INC. ALOCRIL (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALLERGAN INC. ALPHAGAN P 0.1% (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALLERGAN INC. COMBIGAN (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALLERGAN INC. CORDRAN TAPE (TOPICAL) STEROIDS, TOPICAL MEDIUM ALLERGAN INC. FML FORTE (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALLERGAN INC. FML S.O.P. (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALLERGAN INC. LASTACAFT (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALLERGAN INC. LUMIGAN 2.5ML (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALLERGAN INC. LUMIGAN 5ML (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALLERGAN INC. LUMIGAN 7.5ML (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALLERGAN INC. NAMZARIC (ORAL) ALZHEIMER'S AGENTS ALLERGAN INC. NAMZARIC DOSE PACK (ORAL) ALZHEIMER'S AGENTS ALLERGAN INC. PRED MILD (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES AMARIN PHARMA I VASCEPA (ORAL) LIPOTROPICS, OTHER AIMOVIG (SUBCUTANEOUS) ANTIMIGRAINE AGENTS, OTHER ASTRAZENECA SEROQUEL XR (ORAL) ANTIPSYCHOTICS BAUSCH & LOMB ALREX (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS BAUSCH & LOMB BEPREVE (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS BAUSCH & LOMB ISTALOL (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS BAUSCH & LOMB LOTEMAX DROPS (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES BAUSCH & LOMB LOTEMAX OINTMENT (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES BAUSCH & LOMB PROLENSA (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES BAYER,PHARM DIV BETASERON KIT (SUBCUTANE.) MULTIPLE SCLEROSIS AGENTS BAYER,PHARM DIV BETASERON VIAL (SUBCUTANE.) MULTIPLE SCLEROSIS AGENTS BIO PRODUCTS LA GAMMAPLEX (INTRAVEN) IMMUNE GLOBULINS -IDEC AVONEX (INTRAMUSC.) MULTIPLE SCLEROSIS AGENTS BIOGEN-IDEC AVONEX PEN (INTRAMUSC.) MULTIPLE SCLEROSIS AGENTS BIOGEN-IDEC PLEGRIDY (SUBCUTANE.) MULTIPLE SCLEROSIS AGENTS BIOGEN-IDEC TECFIDERA (ORAL) MULTIPLE SCLEROSIS AGENTS BIOGEN-IDEC TECFIDERA STARTER PACK (ORAL) MULTIPLE SCLEROSIS AGENTS BIOGEN-IDEC VUMERITY (ORAL) MULTIPLE SCLEROSIS AGENTS BIOTEST PHARMAC BIVIGAM (INTRAVEN) IMMUNE GLOBULINS BOEHRINGER ING. MIRAPEX ER (ORAL) ANTIPARKINSON'S AGENTS CHIESI ZYFLO (ORAL) LEUKOTRIENE MODIFIERS COVIS PHARMA OMNARIS (NASAL) INTRANASAL RHINITIS AGENTS COVIS PHARMA ZETONNA (NASAL) INTRANASAL RHINITIS AGENTS COVIS PHARMACEU ALTOPREV (ORAL) LIPOTROPICS, STATINS CSL BEHRING LLC HIZENTRA (SUBCUT.) IMMUNE GLOBULINS CSL BEHRING LLC PRIVIGEN (INTRAVEN) IMMUNE GLOBULINS DAIICHI SANKYO, WELCHOL POWDER PACK (ORAL) LIPOTROPICS, OTHER DAIICHI SANKYO, WELCHOL TABLET (ORAL) LIPOTROPICS, OTHER

January 2020 Magellan Rx Management Colorado Medicaid January 7, 2020 Meeting

MANUFACTURER BRAND NAME THERAPEUTIC CLASS ELI LILLY & CO. BAQSIMI (NASAL) GLUCAGON AGENTS ELI LILLY & CO. BASAGLAR KWIKPEN (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS ELI LILLY & CO. EMGALITY PEN (SUBCUTANEOUS) ANTIMIGRAINE AGENTS, OTHER ELI LILLY & CO. EMGALITY SYRINGE 100 MG (SUBCUTANEOUS) ANTIMIGRAINE AGENTS, OTHER ELI LILLY & CO. EMGALITY SYRINGE 120 MG (SUBCUTANEOUS) ANTIMIGRAINE AGENTS, OTHER ELI LILLY & CO. HUMALOG 200 U/ML PEN (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS ELI LILLY & CO. HUMALOG CARTRIDGE (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS ELI LILLY & CO. HUMALOG JUNIOR KWIKPEN (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS ELI LILLY & CO. HUMALOG MIX PEN (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS ELI LILLY & CO. HUMALOG MIX VIAL (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS ELI LILLY & CO. HUMALOG PEN (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS ELI LILLY & CO. HUMALOG VIAL (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS ELI LILLY & CO. HUMATROPE CARTRIDGE (INJECTION) GROWTH HORMONE ELI LILLY & CO. HUMATROPE VIAL (INJECTION) GROWTH HORMONE ELI LILLY & CO. HUMULIN 500 U/M PEN (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS ELI LILLY & CO. HUMULIN 500 U/M VIAL (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS ELI LILLY & CO. HUMULIN 70/30 PEN OTC (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS ELI LILLY & CO. HUMULIN 70/30 VIAL OTC (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS ELI LILLY & CO. HUMULIN PEN OTC (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS ELI LILLY & CO. HUMULIN VIAL OTC (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS EMD SERONO, INC MAVENCLAD (ORAL) MULTIPLE SCLEROSIS AGENTS EMD SERONO, INC REBIF (SUBCUTANE.) MULTIPLE SCLEROSIS AGENTS EMD SERONO, INC REBIF REBIDOSE PEN INJCTR (SUBCUTANE.) MULTIPLE SCLEROSIS AGENTS EMD SERONO, INC SAIZEN CARTRIDGE (INJECTION) GROWTH HORMONE EMD SERONO, INC SAIZEN VIAL (INJECTION) GROWTH HORMONE EMD SERONO, INC SEROSTIM VIAL (INJECTION) GROWTH HORMONE EMD SERONO, INC ZORBTIVE VIAL (INJECTION) GROWTH HORMONE EPI HEALTH LLC CLODERM (TOPICAL) STEROIDS, TOPICAL MEDIUM FERRING PH INC ZOMACTON VIAL (INJECTION) GROWTH HORMONE LABORA CAPEX SHAMPOO (TOPICAL) STEROIDS, TOPICAL LOW , INC. NUTROPIN AQ PEN (INJECTION) GROWTH HORMONE GLAXOSMITHKLINE BECONASE AQ (NASAL) INTRANASAL RHINITIS AGENTS GLAXOSMITHKLINE LOVAZA (ORAL) LIPOTROPICS, OTHER GRIFOLS FLEBOGAMMA DIF (INTRAVEN) IMMUNE GLOBULINS GRIFOLS THERAPE GAMUNEX-C (INJECTION) IMMUNE GLOBULINS GRIFOLS THERAPE XEMBIFY (SUBCUTANEOUS) IMMUNE GLOBULINS GSK CONSUMER HE FLONASE (FUROATE) OTC (NASAL) INTRANASAL RHINITIS AGENTS GSK CONSUMER HE FLONASE (PROPIONATE) OTC (NASAL) INTRANASAL RHINITIS AGENTS HILL DERM DERMA-SMOOTHE-FS (TOPICAL) STEROIDS, TOPICAL LOW IMPAX PHARMACEU RYTARY (ORAL) ANTIPARKINSON'S AGENTS INTERCEPT PHARM OCALIVA (ORAL) BILE SALTS JAZZ PHARMACEUT FAZACLO (ORAL) ANTIPSYCHOTICS JAZZ PHARMACEUT VERSACLOZ (ORAL) ANTIPSYCHOTICS KALA PHARMACEUT INVELTYS (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES KEDRION BIOPHAR GAMMAKED (INTRAVEN) IMMUNE GLOBULINS KEY THERAPEUTIC TRIGLIDE (ORAL) LIPOTROPICS, OTHER KOWA PHARMACEUT LIVALO (ORAL) LIPOTROPICS, STATINS KYOWA KIRIN, IN NOURIANZ (ORAL) ANTIPARKINSON'S AGENTS LEO PHARMA INC. DESONATE GEL (TOPICAL) STEROIDS, TOPICAL LOW MANCHESTER PHAR CHOLBAM (ORAL) BILE SALTS MANNKIND CORPOR AFREZZA CARTRIDGE (INHALATION) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS MAYNE PHARMA IN LEXETTE (TOPICAL) STEROIDS, TOPICAL VERY HIGH MEDA PHARMACEUT DYMISTA (NASAL) INTRANASAL RHINITIS AGENTS MEDA PHARMACEUT EDLUAR (SUBLINGUAL) SEDATIVE HYPNOTICS MEDICURE INTERN ZYPITAMAG (ORAL) LIPOTROPICS, STATINS MEDIMETRIKS PHA BESER KIT (TOPICAL) STEROIDS, TOPICAL MEDIUM MEDIMETRIKS PHA CLODAN KIT (TOPICAL) STEROIDS, TOPICAL VERY HIGH MEDIMETRIKS PHA SYNALAR CREAM KIT (TOPICAL) STEROIDS, TOPICAL MEDIUM MEDIMETRIKS PHA SYNALAR OINTMENT KIT (TOPICAL) STEROIDS, TOPICAL MEDIUM MEDIMETRIKS PHA SYNALAR TS KIT (TOPICAL) STEROIDS, TOPICAL MEDIUM MEDIMETRIKS PHA TOVET KIT (TOPICAL) STEROIDS, TOPICAL VERY HIGH MERCK SHARP & D BELSOMRA (ORAL) SEDATIVE HYPNOTICS MERCK SHARP & D NASONEX (NASAL) INTRANASAL RHINITIS AGENTS MERCK/SCHERING VYTORIN (ORAL) LIPOTROPICS, STATINS MISSION PHARM. TEXACORT (TOPICAL) STEROIDS, TOPICAL LOW EXELON (TRANSDERM.) ALZHEIMER'S AGENTS NOVARTIS EXTAVIA KIT (SUBCUTANE.) MULTIPLE SCLEROSIS AGENTS NOVARTIS EXTAVIA VIAL (SUBCUTANE.) MULTIPLE SCLEROSIS AGENTS NOVARTIS GILENYA (ORAL) MULTIPLE SCLEROSIS AGENTS NOVARTIS LESCOL XL (ORAL) LIPOTROPICS, STATINS NOVARTIS MAYZENT DOSE PACK (ORAL) MULTIPLE SCLEROSIS AGENTS NOVARTIS MAYZENT TABLET (ORAL) MULTIPLE SCLEROSIS AGENTS

January 2020 Magellan Rx Management Colorado Medicaid January 7, 2020 Meeting

MANUFACTURER BRAND NAME THERAPEUTIC CLASS NOVO NORDISK FIASP FLEXTOUCH PEN (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS NOVO NORDISK FIASP PENFILL (SUBCUT) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS NOVO NORDISK FIASP VIAL (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS NOVO NORDISK LEVEMIR PENS (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS NOVO NORDISK LEVEMIR VIAL (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS NOVO NORDISK NORDITROPIN PEN (INJECTION) GROWTH HORMONE NOVO NORDISK NOVOLIN 70/30 PEN OTC (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS NOVO NORDISK NOVOLIN 70/30 VIAL OTC (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS NOVO NORDISK NOVOLIN VIAL OTC (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS NOVO NORDISK NOVOLOG CARTRIDGE (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS NOVO NORDISK NOVOLOG MIX PEN (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS NOVO NORDISK NOVOLOG MIX VIAL (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS NOVO NORDISK NOVOLOG PEN (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS NOVO NORDISK NOVOLOG VIAL (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS NOVO NORDISK TRESIBA FLEXTOUCH 100 U/ML PEN (SUBCUTANEOUS) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS NOVO NORDISK TRESIBA FLEXTOUCH 200 U/ML PEN (SUBCUTANEOUS) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS NOVO NORDISK TRESIBA VIAL (SUBCUTANEOUS) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS NOVO NORDISK-WA NOVOLIN 70/30 PEN OTC (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS OCTAPHARMA USA CUTAQUIG (SUBCUT) IMMUNE GLOBULINS OCTAPHARMA USA OCTAGAM (INTRAVEN) IMMUNE GLOBULINS OPTINOSE US, IN XHANCE (NASAL) INTRANASAL RHINITIS AGENTS OTSUKA AMERICA ABILIFY MYCITE (ORAL) ANTIPSYCHOTICS OTSUKA AMERICA REXULTI (ORAL) ANTIPSYCHOTICS US PHARM PANZYGA (INTRAVEN) IMMUNE GLOBULINS PHARMACIA/UPJHN GENOTROPIN CARTRIDGE (INJECTION) GROWTH HORMONE PHARMACIA/UPJHN GENOTROPIN DISP SYRIN (INJECTION) GROWTH HORMONE PHARMADERM/SAND PANDEL (TOPICAL) STEROIDS, TOPICAL MEDIUM PROMIUS PHARMA SERNIVO SPRAY (TOPICAL) STEROIDS, TOPICAL HIGH L INTERMEZZO (SUBLINGUAL) SEDATIVE HYPNOTICS RANBAXY/SUN PHA ULTRAVATE LOTION (TOPICAL) STEROIDS, TOPICAL VERY HIGH RETROPHIN, INC. CHENODAL (ORAL) BILE SALTS SANDOZ APEXICON E (TOPICAL) STEROIDS, TOPICAL VERY HIGH SANDOZ OMNITROPE CARTRIDGE (INJECTION) GROWTH HORMONE SANDOZ OMNITROPE VIAL (INJECTION) GROWTH HORMONE SANOFI-AVENTIS ADMELOG SOLOSTAR PEN (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS SANOFI-AVENTIS ADMELOG VIAL (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS SANOFI-AVENTIS APIDRA SOLOSTAR PEN (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS SANOFI-AVENTIS APIDRA VIAL (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS SANOFI-AVENTIS AUBAGIO (ORAL) MULTIPLE SCLEROSIS AGENTS SANOFI-AVENTIS LANTUS SOLOSTAR PEN (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS SANOFI-AVENTIS LANTUS VIAL (SUBCUTANE.) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS SANOFI-AVENTIS TOUJEO MAX SOLOSTAR PEN (SUBCUTANEOUS) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS SANOFI-AVENTIS TOUJEO SOLOSTAR PEN (SUBCUTANEOUS) HYPOGLYCEMICS, INSULIN AND RELATED AGENTS SANTARUS INC. FENOGLIDE (ORAL) LIPOTROPICS, OTHER SEBELA PHARMACE MICORT-HC (TOPICAL) STEROIDS, TOPICAL LOW SETON PHARMACEU HYDROCORTISONE AC/LIDOCAINE (RECTAL) HEMORRHOIDAL PREPARATIONS SHIRE US INC. CUVITRU (SUBCUT.) IMMUNE GLOBULINS SHIRE US INC. GAMMAGARD LIQUID (INJECTION) IMMUNE GLOBULINS SHIRE US INC. GAMMAGARD S-D (INTRAVEN) IMMUNE GLOBULINS SHIRE US INC. HYQVIA (SUBCUT.) IMMUNE GLOBULINS SHIRE/TAKEDA PH CUVITRU (SUBCUT.) IMMUNE GLOBULINS SUN PHARMA GLOB EZALLOR SPRINKLE (ORAL) LIPOTROPICS, STATINS SUN PHARMA GLOB XELPROS (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS SUN PHARMACEUTI HALOG OINTMENT (TOPICAL) STEROIDS, TOPICAL HIGH SUN PHARMACEUTICALS BROMSITE (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES SUN PHARMACEUTICALS HALOG OINTMENT (TOPICAL) STEROIDS, TOPICAL HIGH SUN PHARMACEUTICALS KENALOG AEROSOL (TOPICAL) STEROIDS, TOPICAL HIGH SUN PHARMACEUTICALS ULTRAVATE X PAC CREAM (TOPICAL) STEROIDS, TOPICAL VERY HIGH SUN PHARMACEUTICALS ULTRAVATE X PAC OINTMENT (TOPICAL) STEROIDS, TOPICAL VERY HIGH SUNOVION PHARMA LATUDA (ORAL) ANTIPSYCHOTICS TAKEDA PHARMACE ROZEREM (ORAL) SEDATIVE HYPNOTICS TARO PHARM USA TOPICORT SPRAY (TOPICAL) STEROIDS, TOPICAL HIGH TEVA PHARMACEUTICALS AZILECT (ORAL) ANTIPARKINSON'S AGENTS TEVA PHARMACEUTICALS COPAXONE 20 MG/ML (SUBCUTANE.) MULTIPLE SCLEROSIS AGENTS TEVA PHARMACEUTICALS COPAXONE 40 MG/ML (SUBCUTANE.) MULTIPLE SCLEROSIS AGENTS TEVA SPECIALTY QNASL 40 (NASAL) INTRANASAL RHINITIS AGENTS TEVA SPECIALTY QNASL 80 (NASAL) INTRANASAL RHINITIS AGENTS TEVA USA AJOVY (SUBCUTANEOUS) ANTIMIGRAINE AGENTS, OTHER UCB PHARMA NEUPRO (TRANSDERM) ANTIPARKINSON'S AGENTS US WORLDMEDS XADAGO (ORAL) ANTIPARKINSON'S AGENTS VALEANT BRYHALI (TOPICAL) STEROIDS, TOPICAL VERY HIGH VALEANT VYZULTA (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS

January 2020 Magellan Rx Management Colorado Medicaid January 7, 2020 Meeting

MANUFACTURER BRAND NAME THERAPEUTIC CLASS VALEANT ZELAPAR (ORAL) ANTIPARKINSON'S AGENTS VALEANT/BAUSCH LOTEMAX GEL (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES VERTICAL PHARM OSMOLEX ER (ORAL) ANTIPARKINSON'S AGENTS PHARM PHOSPHOLINE IODIDE (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS XERIS PHARMACEU GVOKE PEN (SUBCUTANEOUS) GLUCAGON AGENTS XERIS PHARMACEU GVOKE SYRINGE (SUBCUTANEOUS) GLUCAGON AGENTS

January 2020 Magellan Rx Management