AME Group
Elect Rx Drug Formulary February 2023
Personal Importation Program (90-day supplies)
Brand Medications Available Through Elect Rx
Please call Customer Service if you do not see your Drug listed!
Elect Rx Customer Service: 1-855-353-2879
Open 8:30AM to 4:30PM M-F
Physician Fax: 1-833-353-2879
Actemra Combipatch Fareston - PA/G Kombiglyze XR Nuvaring - PA/G Santyl Ointment Toviaz
Admelog Combivent Farxiga Kynmobi Ocaliva* Saphris - PA/G Tradjenta
Advair Diskus - PA/G Complera* Ferriprox - PA/G Lacrisert Odefsey Savaysa Travatan Z - PA/G
Advair Inhaler Copaxone - PA/G Fetzima Lantus - PA/G Ofev 100MG* Scemblix* Trelegy Ellipta
Afinitor*- PA/G Corlanor FIASP - PA/G Latuda Ofev150MG* Selzentry* Tremfya*
Aklief Cream Cosentyx Flovent Lenvima* Olumiant* Serevent Tresiba
Alecensa* Cosopt PF Flovent HFA Inhaler Levemir Omnaris Nasal Spray Seroquel XR - PA/G Tribenzor - PA/G
Alomide Creon Forteo - PA/G Lexiva*- PA/G Ongentys Silenor - PA/G Trintellix
Alphagan P - PA/G Crinone Gel Fosamax D Lialda - PA/G Onglyza Simbrinza Triumeq*
Alrex Cuprimine - PA/G Frova - PA/G Linzess Opsumit* Simponi* Trulance
Alvesco Daliresp Genotropin Locoid Lipocream - PA/G Oracea - PA/G Skyrizi Trulicity 0.75mg
Anoro Ellipta Daraprim - PA/G Genvoya* Lonsurf Oralair Slynd Trulicity 1.5mg
Apidra Delstrigo Gilenya* Lotemax Eye Drops- PA/G Orencia Soliqua Tudorza Pressair
Aptiom Denavir Cream Gilotrif* Lupron Depot Orilissa Somatuline* Tykerb - PA/G
Arazlo Lotion Descovy* Gleostine Lynparza* Orthovisc Soolantra - PA/G Uceris - PA/G
Arnuity Ellipta Dexilant - PA/G Glyxambi Mayzent - 0.25MG* Osphena Spiriva Velphoro
Asacol HD - PA/G Dipentum Grastek Mayzent - 2MG* Otezla* Spiriva Respimat Veltassa
Asmanex Divigel Humalog - PA/G Mekinst - 0.5MG* Oxytrol Sprycel* Vemlidy
Astagraf XL Dovato Humatrope Mekinst - 2MG* Ozempic Steglatro Verquvo 10mg
Atrovent Duaklir Pressair Humira* Mestinon 180MG - PA/G Pentasa Steglujan Verzenio*
Aubagio* Duavee Humulin Migranal - PA/G Pifeltro Stelara* Viberzi
Avonex Dulera Ibrance* Mirvaso Piqray* Stiolto Victoza
Azelex Duobrii Imbruvica* Motegrity Plaquenil - PA/G Stivarga Votrient*
Azilect - PA/G Dymista - PA/G Incruse Ellipta Multaq Pradaxa Stribild* Vraylar
Azopt - PA/G Edarbi Inlyta* Myfembree Premarin Striverdi Vumerity
Baqsimi Edarbyclor Intelence - PA/G Myleran Prempro Sustiva - PA/G Vyzulta
Basaglar - PA/G Edecrin - PA/G Intrarosa Myrbetriq Prestalia Sutent - 12.5MG* - PA/G Wakix
Benlysta Edurant Invega - PA/G Natazia Prevacid Solutab - PA/G Sutent - 25MG* - PA/G Xadago
Bepreve - PA/G Eliquis Invokamet Nesina - PA/G Prezcobix Sutent - 50MG* - PA/G Xarelto
Besivance Elmiron Invokana Neulasta - PA/G Prezista* Symbicort Inhaler- PA/G Xeljanz
Betoptic S Emcyt Iressa* Neupogen - PA/G Promacta* Symtuza* Xeljanz XR
Bevespi Aerosphere Emtriva - PA/G Isentress* Neupro Pulmicort - PA/G Synarel Xenazine - PA/G
Biktarvy* Enbrel* Isentress HD* Nevanac Pulmozyme* Synjardy Xenical
Binosto Entocort - PA/G Jakafi* Nexavar* Qtern Taclonex - PA/G Xerese Cream
Bosulif* Entresto Janumet Nexium Packets - PA/G Qvar Inhaler Tafinlar* Xifaxan - 200MG
Breo Ellipta Entyvio* Janumet XR Nexletol Qvar Redihaler Tagrisso* Xifaxan - 550MG
Breztri Aerosphere Envarsus Januvia Nexlizet Rebif Taltz* Xigduo XR
Brilinta Epiduo Forte Jardiance Nextstellis Relpax - PA/G Tarceva*- PA/G Xiidra
Briviact Epivir HBV - PA/G Jentadueto Nitrolingual - PA/G Renagel - PA/G Tasigna* Xtandi
Cabometyx* Erleada* Jublia Topical Solution Nocdurna Restasis Tasmar - PA/G Zelapar
Canasa - PA/G Esbriet Juluca* Norditropin Rexulti Tazorac Cream - PA/G Zeposia*
Cardura XL Estring Kaletra*- PA/G Noritate Ridaura Tazorac Gel Ziana Gel - PA/G
Cequa Estrogel Gel Kazano - PA/G Novolin Rinvoq Tecfidera*- PA/G Zolinza*
Cimzia Eucrisa Ointment Kerendia Novolog - PA/G Ryaltris Nasal Spray Tekturna - PA/G Zomig Spr - PA/G
Ciprodex Ear Drops - PA/G Evotaz Kesimpta* Nubeqa Rybelsus Tivicay* Zortress*- PA/G
Combigan Exelon Patches - PA/G Kisqali* Nucala Sancuso Toujeo Solostar Zovirax Cream - PA/G
Zyclara - PA/G
HD plan members have a $0 co-pay on diabetic drugs
PA/G - Prior Authorization Required by TrueScripts - Generic Available - TrueScripts Needs to Check Price of Generic
*This medication will only be dispensed as a one month supply due to the high cost of this medication.
Excluded through TS
Diclegis
Glumetza - PA/G
Movantik
Vimovo
Treximet
Cambia