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The formulary list was last updated on 09/01/07, please be advised the information listed may not reflect the most current data and may be updated at any time without notice.
Please call HNE Member Services at (413) 787-4000 or
(800) 310-2835 for assistance.
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Alphabetic Listing Tier 2
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Tier 2 Brand/Formulary Drug Listing
Brand/Formulary Drugs (Tier 2) are marketed under a trademarked brand name, usually by one manufacturer, and do not have less costly generic equivalents. Brand/Formulary Drugs are selected based on a review of the relative safety, effectiveness and cost of the many FDA-approved drugs on the market. Your copayment for Brand/Formulary Drugs is higher than for Generic Drugs, but lower than for Brand/Non-Formulary Drugs.
* indicates covered over the counter (OTC) medications
**Indicates a medication with a Limit/PA or Step Therapy, please click limitations link above.
NOTE: The contents of this Formulary are subject to change at any time without member notification.
A
| Actonel |
| Actonel w/ calcium |
| Actos |
| Acular |
| Acular LS |
| Acular PF |
| Adderall XR |
| Advair Diskus |
| Advair HFA |
| Aerochamber |
| Agenerase |
| Agrylin |
| Akne-Mycin |
| Albenza |
| Alinia |
| Alkeran |
| Alphagan P |
| Alupent |
| Androderm |
| Apidra |
| Aptivus |
| Aquasol A |
| Aricept |
| Arimidex |
| Aristocort A |
| Armour thyroid |
| Asacol |
| Asmanex |
| Astelin |
| Atripla |
| Atrovent inhaler |
| Augmentin Susp |
| Augmentin XR |
| Avalide |
| Avandia |
| Avapro |
| Avonex |
| Azelex |
| Azopt |
| Azulfidine EN |
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B
| Bactroban |
| Beconase |
| Betaseron |
| Betoptic S |
| Blephamide or Vasocidin |
| Bromfenex PD |
| Byetta |
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C
| Calcimar |
| Capitrol |
| Carnitor |
| Casodex |
| Catapres TTS-1 |
| Catapres TTS-2 |
| Catapres TTS-3 |
| Caverject |
| Celebrex |
| Cellcept |
| Centany |
| Cerumenex |
| Cetrotide |
| Chemet |
| Chloromycetin Otic |
| Cibalith-S |
| CiproDex |
| Cleocin Pediatric |
| Climara Pro |
| Combipatch |
| Combivent |
| Combivir |
| Compazine Spansule |
| Comvax |
| Concerta |
| Condylox |
| Copaxone |
| Coreg |
| Cortone |
| Cosopt |
| Creon 10 |
| Creon 20 |
| Creon 5 |
| Crinone |
| Crixivan |
| Cuprimine |
| Cyclogyl |
| Cytomel |
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D
| Dantrium |
| Daraprim |
| Deconamine |
| Deconamine SR |
| Depakote |
| Depakote |
| Depakote ER |
| Depakote ER |
| Depakote Sprinkle |
| Depakote Sprinkles |
| Depakote Sprinkles |
| Dermasmooth/FS |
| Dexacort Turbinaire |
| DHT |
| Diamox Sequels |
| Dilantin Infatab |
| Dilatrate-SR |
| Dilaudid-HP |
| Dimetane-DC |
| Diovan |
| Diovan HCT |
| Diprolene |
| Diprolene AF |
| Dovonex |
| Drithrocreme |
| Drithro-Scalp |
| Drysol |
| Drysol Dabamatic |
| Duragesic |
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E
| Edex |
| Effexor XR |
| Emtriva |
| Enbrel |
| Enfamil Natalins |
| Engerix-B |
| Entocort EC |
| Epi-pen Epi-pen Jr |
| Epivir |
| Epogen |
| Epzicom |
| Ergamisol |
| Ergomar |
| Eryped |
| Eryped Chewable |
| Estrace Vag. Cream |
| Estratab |
| Estratest |
| Estratest HS |
| Estring |
| Estrostep |
| Estrostep FE |
| Eurax |
| Evista |
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F
| Fansidar |
| Femara |
| Femhrt |
| Femring |
| Flavored Colytely |
| Flomax |
| Flovent |
| Flovent Rotadisk |
| Floxin Otic |
| Follistim/Anatagon Kit |
| Foradil Aerolizer |
| Fortovase |
| Fosamax |
| Fosamax plus D |
| Furadantin Suspension |
| Furoxone |
| Fuzeon |
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G
| Ganirelix |
| Gel-Kam |
| Glucagon |
| Glucagon Emergency kit |
| Gonal-F |
| Grifulvin V |
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H
| Haldol Inj |
| Havrix |
| Hepsera |
| Humalog |
| Humegon |
| Humira |
| Humira |
| Humulin |
| Hydromet |
| hytekerol |
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I
| Imitrex, injection |
| Imitrex, intranasal |
| Imitrex, oral |
| Insulin, all Lilly products |
| Insulin, all Novo products |
| Intal inhaler |
| Intron A |
| Invirase |
| Isopto Atropine |
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J
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K
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L
| Lamictal |
| Lamictal CD |
| Lamprene |
| Lancets |
| Lantus |
| Lantus Solostar |
| Lente Insulin |
| Leukeran |
| Levaquin |
| Levemir |
| Levothroid |
| Lexapro |
| Lexiva |
| Liquid Pred |
| Lovenox |
| Lumigan |
| Lysodren |
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M
| Matulane |
| Maxair/ Maxair Autohaler |
| Menest |
| Mephyton |
| Mepron |
| Mesnex |
| Mestinon Timespan |
| Metandren |
| Methergine |
| MetroCreme |
| Metrodin |
| Metrogel Vaginal |
| Migranal Nasal Spray |
| Mintezol |
| Mirapex |
| Mission Prenatal |
| Mission Prenatal FA |
| MUSE |
| Myambutol |
| Mycelex Troche |
| Mycobutin |
| Myfortic |
| Myleran |
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N
| Naftin |
| Naftin Gel |
| Namenda |
| Nardil |
| Nasacort |
| Nasonex |
| Nebupent |
| Nembutal |
| Nephrocap |
| Nestabs FA |
| Niacor |
| Niaspan |
| Nizoral Shampoo |
| Noritate |
| Norvir |
| Novolin |
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O
| Obstetrix-100 |
| O-Cal FA |
| Optivar |
| Orap |
| Oraspan-FA |
| Orfadin |
| Ortho Dienestrol |
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P
| Pancrease |
| Pancrease MT 10 |
| Pancrease MT 16 |
| Pancrease MT 20 |
| Pancrease MT 4 |
| Pediarix |
| Pentasa |
| Pergonal |
| Phisohex |
| Phospholine Iodide |
| Pilopine HS |
| Plavix |
| Poly Vi Flor |
| Poly Vi Flor/ Iron |
| Precose |
| Pred Mild |
| Premarin |
| Premarin Vaginal Cream |
| Premphase |
| Prempro |
| Prempro Low Dose |
| PrevPac |
| Prezista |
| Proair |
| Prochieve |
| Procrit |
| Proctofoam HC |
| Profasi HP |
| Prograf |
| Protonix |
| Protopic |
| Pulmicort Respule |
| Pulmicort Turbuhaler |
| Pulmozyme |
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Q
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R
| Rapamune |
| Rebetol 40mg/ml sol |
| Rebetron |
| Rebetron 600 |
| Rebif |
| Recombivax HB |
| Relion N Innolet |
| Renagel |
| Repronex |
| Rescriptor |
| Retrovir |
| Revatio |
| Reyataz |
| Rhinocort |
| Rhinocort Aqua |
| Riomet |
| Risperdal |
| Risperdal M tabs |
| Rondec |
| Rondec TR |
| Rowasa Rectal |
| Roxanol |
| Roxicet |
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S
| Sandimmune |
| Sandostatin |
| Sansert |
| Semprex-D |
| Semprex-D |
| Serevent |
| Serevent Diskus |
| Seroquel |
| Seroquel XR |
| Singulair |
| Slo-Phyllin |
| Solatene |
| Solganal |
| Sorbitrate |
| Spiriva |
| Stalevo |
| Suprax |
| Sustiva |
| Symlin |
| Synarel |
| Synthroid |
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T
| Tegretol XR |
| Teslac |
| Test Strips- Roche/Lifescan |
| Tev-Tropin |
| Thalomid |
| Thioguanine |
| Tilade |
| TOBI |
| Tobradex |
| Tobradex Opth. Drops |
| Tobradex Opth. Oint. |
| Topamax |
| Torecan |
| Transderm Scop |
| Tri Vi Flor/Iron |
| TriCor |
| Trizivir |
| Trusopt |
| Truvada |
| Tussionex |
| Twinrix |
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U
| Uni-Dur |
| Uniretic |
| Unithroid |
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V
| Vagifem |
| Valtrex |
| Vancenase Pockethaler |
| Vanceril |
| Vanceril DS |
| Vancocin |
| Vaqta |
| Ventolin Rotocap |
| Viagra |
| Videx |
| Videx EC |
| Viokase |
| Vioxx |
| Vira- A |
| Viracept |
| Viramune |
| Vytorin |
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W
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X
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Y
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Z
| Zavesca |
| Zenate |
| Zerit |
| Zetia |
| Ziagen |
| Zmax |
| Zomig |
| Zomig Nasal Spray |
| Zomig ZMT |
| Zovirax oint/cream |
| Zyprexa |
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