Mandatory Specialty Pharmacy (MSP) Products
This list contains prescribed drugs allowed through our specialty pharmacy. All products listed
may not be covered for all members. Please refer to your complete formulary listing and
summary of benefits for detailed participation and coverage information including whether
prior authorization, step therapy and quantity limitations apply. All dosage forms and strengths
for the medications included in this listing may not be available. This list is not all-inclusive and
is subject to change. For insurance related questions, contact the Dean Health Plan Customer
Care Center at (800) 279-1301.
Contact the Dean Clinic Pharmacy at (800) 279-8200.
ACTIMMUNE INJ
ADCIRCA TAB
adefovir dipivoxil tab
abacavir/
lamivudine/
zidovudine tab
AFINITOR DISPERZ
AFINITOR TAB
ALFERON-N INJ
APTIVUS CAP
ARANESP INJ
ATRIPLA TAB
AUBAGIO TAB
AVONEX INJ
BOSULIF TAB
calcitriol inj
capecitabine tab
CAPRELSA TAB
CAYSTON INH
CIMZIA INJ
COMBIVIR TAB
COMETRIQ ORAL KIT
COMPLERA TAB
COPAXONE INJ
CRIXIVAN CAP
didanosine DR cap
EDURANT TAB
EMTRIVA CAP
EMTRIVA SOLN
ENBREL INJ
ENBREL SURECLICK
INJ
EPIVIR HBV SOLN
EPIVIR TAB
EPOGEN INJ
EPZICOM TAB
ERIVEDGE CAP
EVOTAZ TAB
EXJADE TAB
EXTAVIA INJ
FABRAZYME INJ.
FERRIPROX TAB
FORTEO INJ
FUZEON INJ
GILENYA CAP
GLEEVEC TAB
HARVONI TAB
HIZENTRA INJ
HUMIRA INJ
HUMIRA PEN INJ
HYCAMTIN CAP
ICLUSIG TAB
IMBRUVICA CAP
INCRELEX INJ
INFERGEN INJ
INLYTA TAB
INTELENCE TAB
INTRON-A INJ
INVIRASE TAB
IRESSA TAB
ISENTRESS POWDER
PACK
ISENTRESS TAB
JAKAFI TAB
KALETRA SOLN
KALETRA TAB
KALYDECO PAK
KALYDECO TAB
KINERET INJ
KORLYM TAB
KUVAN TAB
lamivudine soln
lamivudine tab
KUVAN POWDER
PACK
lamivudine tab
100mg
abacavir tab
lamivudine/zidovudine
tab
LYSODREN TAB
LEUKINE INJ
LEXIVA SUSP
LEXIVA TAB
MESNEX TAB
MIACALCIN INJ
NEULASTA INJ
NEUMEGA INJ
NEUPOGEN INJ
nevirapine ER tab
NEVIRAPINE SUSP
nevirapine tab
NEXAVAR TAB
NORDITROPIN INJ
NORVIR CAP
NORVIR SOLN
octreotide inj
ORENCIA SC INJ
OTEZLA TAB
PEGASYS INJ
PEGASYS INJ KIT
OTEZLA STARTER
PACK
PEG-INTRON INJ
PREZCOBIX TAB
PREZISTA SUSP
PREZISTA TAB
PROCRIT INJ
PROMACTA TAB
PULMOZYME INH
SOLN
REBETOL SOLN
REBIF INJ
RELISTOR INJ
RESCRIPTOR TAB
RETROVIR CAP
RETROVIR SYRUP
REVLIMID CAP
REYATAZ CAP
REYATAZ POWDER
ribasphere cap
RIBATAB
ribavirin tab
SABRIL POWDER
SABRIL TAB
SANDOSTATIN INJ
SELZENTRY TAB
SIGNIFOR INJ
SIMPONI INJ
SOMAVERT INJ
SPRYCEL TAB
stavudine cap
stavudine soln
STELARA INJ
STIVARGA TAB
STRIBILD TAB
SUSTIVA CAP
SUSTIVA TAB
SUTENT CAP
SYLATRON KIT INJ
TARCEVA TAB
TARGRETIN CAP
TARGRETIN GEL
TASIGNA CAP
TECFIDERA CAP
TECFIDERA STARTER
PACK
temozolomide cap
THALOMID CAP
TOBI PODHALER
tobramycin neb
tretinoin cap
TRUVADA TAB
TYKERB TAB
TYVASO INH SOLN
VENTAVIS INH SOLN
VIDEX SOLN
VIRACEPT TAB
VIRAMUNE XR TAB
VIREAD TAB
VITEKTA TAB
VOTRIENT TAB
XALKORI CAP
XELJANZ TAB
XENAZINE TAB
XTANDI CAP
XYREM SOLN
zidovudine tab
ZELBORAF TAB
ZOLINZA CAP
Zidovudine cap
ZYDELIG TAB
Zidovudine syrup
ZYTIGA TAB