Multiple Sclerosis Agents
Showing 1–12 of 40 results
NAME | ALSO KNOW AS | DRUG CATEGORY | FORMULARY CATEGORY | WHAT WE COVER | COST SHARE |
|---|---|---|---|---|---|
|
Lemtrada Soln 12 Mg/1.2Ml (Brand) |
Multiple Sclerosis Agents |
MA |
Administered in Medical Office |
N/A |
|
|
Dalfampridine Tb12 10Mg (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Teriflunomide Tabs 14Mg (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Teriflunomide Tabs 7Mg (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Interferon Beta-1A Kit 30Mcg/Vial (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Interferon Beta-1A Ajkt 30Mcg/0.5Ml (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Interferon Beta-1A Pskt 30Mcg/0.5Ml (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Monomethyl Fumarate Cpdr 95Mg (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Interferon Beta-1B Kit .3Mg (Generic) |
Multiple Sclerosis Agents |
2 |
Formulary Brand |
$38 |
|
|
Glatiramer Acetate Sosy 20Mg/Ml (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Glatiramer Acetate Sosy 40Mg/Ml (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Ampyra Tb12 10 Mg (Brand) |
Multiple Sclerosis Agents |
1 |
Generic |
$14 |
|
|
Interferon Beta-1B Kit .3Mg (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Gilenya Caps 0.5 Mg (Brand) |
Multiple Sclerosis Agents |
1 |
Generic |
$14 |
|
|
Fingolimod Hcl Caps .25Mg (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Fingolimod Hcl Caps .5Mg (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Glatopa Sosy 20 Mg/Ml (Brand) |
Multiple Sclerosis Agents |
1 |
Generic |
$14 |
|
|
Copaxone Sosy 20 Mg/Ml (Brand) |
Multiple Sclerosis Agents |
1 |
Generic |
$14 |
|
|
Glatopa Sosy 40 Mg/Ml (Brand) |
Multiple Sclerosis Agents |
1 |
Generic |
$14 |
|
|
Copaxone Sosy 40 Mg/Ml (Brand) |
Multiple Sclerosis Agents |
1 |
Generic |
$14 |
|
|
Baclofen Packet 10 mg (Generic) |
Multiple Sclerosis Agents ⋅ Skeletal Muscle Relaxants |
3 |
Non-Formulary Brand |
$68 |
|
|
Baclofen Packet 20 mg (Generic) |
Multiple Sclerosis Agents ⋅ Skeletal Muscle Relaxants |
3 |
Non-Formulary Brand |
$68 |
|
|
Baclofen Packet 5 mg (Generic) |
Multiple Sclerosis Agents ⋅ Skeletal Muscle Relaxants |
3 |
Non-Formulary Brand |
$68 |
|
|
Siponimod Fumarate Tbpk .25Mg (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Siponimod Fumarate Tabs .25Mg (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Siponimod Fumarate Tabs 2Mg (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Tysabri Conc 300 Mg/15Ml (Brand) |
Multiple Sclerosis Agents |
MA |
Administered in Medical Office |
N/A |
|
|
Ocrevus Soln 300 Mg/10Ml (Brand) |
Multiple Sclerosis Agents |
MA |
Administered in Medical Office |
N/A |
|
|
Ponesimod Tabs 20 Mg (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Ponesimod Tabs Therapy Pack (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Interferon Beta-1A Soaj 22Mcg/0.5Ml (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Interferon Beta-1A Soaj 44Mcg/0.5Ml (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Interferon Beta-1A Soaj (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Interferon Beta-1A Sosy 22Mcg/0.5Ml (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |
|
|
Interferon Beta-1A Sosy 44Mcg/0.5Ml (Generic) |
Multiple Sclerosis Agents |
3 |
Non-Formulary Brand |
$68 |