What are some drugs that require prior authorization?
Some medications require approval beyond the clinician’s prescription before they can be dispensed. This process ensures appropriate use of certain drugs which are approved for very specific conditions. When prescribing any of these drugs, the clinician will submit a prior authorization form to the Pharmacy, documenting the clinical need for the medication as well as other clinical criteria related to the use of the medication. This form will then be reviewed by a clinical team. This team will work with your clinician to review the request and develop the optimal therapy for you. If the request is approved, a member of this clinical team will notify you of the approval. If the request is not approved, both you and prescribing clinician will be notified. Denials can be appealed through the Yale Health Plan Appeal process. Below is a list of drugs that are affected by this process. Prior authorization is required for these medications as well as for all brand name drugs for which there a
