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This is a listing of all of the drugs covered by MassHealth. Please select a letter to see drugs listed by that letter, or enter the name of the drug you wish to search for.

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MassHealth Drug List table
Drug - Brand Name (Generic Name) Class
abacavirdrugId:137 ANTIVIRALS
abacavir / dolutegravir / lamivudinedrugId:4642 PD ANTIVIRALS
abacavir / lamivudinedrugId:138 ANTIVIRALS
abacavir / lamivudine / zidovudinedrugId:139 ANTIVIRALS
abaloparatidedrugId:6362 - PA HORMONE AGENTS
abataceptdrugId:140 - PA IMMUNOMODULATOR
Abelcet (amphotericin B lipid complex) ANTIBIOTICS
abemaciclibdrugId:6410 - PA CHEMOTHERAPY
Abilify # (aripiprazole tablet) - PA < 6 years and PA > 30 units/month; See Table 24drugId:90; See Table 71drugId:4180 ANTIPSYCHOTIC
Abilify Maintena (aripiprazole extended-release injection) - PA; See Table 24drugId:2717; See Table 71drugId:4200 ANTIPSYCHOTIC
Abilify Mycite (aripiprazole tablet with sensor) - PA; See Table 24drugId:7230; See Table 71drugId:7231 ANTIPSYCHOTIC
abiraterone 125 mgdrugId:6824 - PA CHEMOTHERAPY
abiraterone 250 mg, 500 mgdrugId:2297 - PA CHEMOTHERAPY
abobotulinumtoxinAdrugId:141 - PA BIOLOGICAL
Abraxane (paclitaxel injectable suspension)drugId:1468 CHEMOTHERAPY
Absorica (isotretinoin-Absorica)drugId:2881 - PA DERMATOLOGICAL
Abstral (fentanyl sublingual tablet)drugId:2157 - PA OPIOID ANALGESICS
acalabrutinibdrugId:6483 - PA CHEMOTHERAPY
Acanya (clindamycin / benzoyl peroxide-Acanya)drugId:262 - PA DERMATOLOGICAL
acarbosedrugId:143 DIABETIC AGENTS
Accolate (zafirlukast)drugId:1816 - PA BRONCHODILATORS
AccunebdrugId:168 # (albuterol inhalation solution)drugId:168 BRONCHODILATORS
AccuprildrugId:1620 # (quinapril)drugId:1620 CARDIOVASCULAR
AccureticdrugId:1621 # (quinapril / hydrochlorothiazide)drugId:1621 CARDIOVASCULAR
acebutololdrugId:144 CARDIOVASCULAR
Acetadote (acetylcysteine injection) ^ ANTIDOTES
acetaminophen / codeinedrugId:146 - PA < 12 years and PA > 4 g/day acetaminophen and PA > 360 mg/day codeine OPIOID ANALGESICS
acetaminophendrugId:145 * - PA > 4 g/day ANALGESICS
acetazolamidedrugId:147 CARDIOVASCULAR
acetic aciddrugId:148 OTIC PREPARATIONS
acetic acid / aluminum acetatedrugId:2107 OTIC PREPARATIONS
acetic acid / hydrocortisonedrugId:149 OTIC PREPARATIONS
acetohydroxamic acid ANTIBIOTICS
acetylcholine chloridedrugId:1982 OPHTHALMIC PREPARATIONS
acetylcysteine MUCOLYTICS
acetylcysteine injection ^ ANTIDOTES
AciphexdrugId:1624 # (rabeprazole delayed-release tablet)drugId:1624 - PA > 30 units/month PROTON PUMP INHIBITORS
Aciphex Sprinkle (rabeprazole delayed-release capsule)drugId:2882 - PA PROTON PUMP INHIBITORS
acitretindrugId:153 DERMATOLOGICAL
aclidinium / formoteroldrugId:7330 - PA BRONCHODILATORS
aclidiniumdrugId:2649 - PA > 1 inhaler/month BRONCHODILATORS
acrivastine / pseudoephedrinedrugId:1608 - PA DECONGESTANT
Actemra (tocilizumab)drugId:1719 - PA IMMUNOMODULATOR
Acthar (corticotropin)drugId:294 - PA HORMONE AGENTS
Acthib (haemophilus B conjugate vaccine-Acthib)drugId:693 1 BIOLOGICAL
ActigalldrugId:1774 # (ursodiol)drugId:1774 BILE THERAPY
Actimmune (interferon gamma-1b)drugId:829 CHEMOTHERAPY
Actiq (fentanyl transmucosal system)drugId:844 - PA OPIOID ANALGESICS
Activella # (estradiol / norethindrone-Activella) HORMONE REPLACEMENT THERAPY
Actonel (risedronate)drugId:1439 - PA ELECTROLYTES AND NUTRIENTS
Actoplus Met (pioglitazone / metformin)drugId:1536 - PA DIABETIC AGENTS
Actoplus Met XR (pioglitazone / metformin extended-release)drugId:1937 - PA DIABETIC AGENTS
ActosdrugId:1534 # (pioglitazone)drugId:1534 DIABETIC AGENTS
AculardrugId:2270 # (ketorolac 0.5% ophthalmic solution)drugId:2270 OPHTHALMIC PREPARATIONS
Acular LSdrugId:2271 # (ketorolac 0.4% ophthalmic solution)drugId:2271 OPHTHALMIC PREPARATIONS
Acuvail (ketorolac 0.45% ophthalmic solution)drugId:999 - PA OPHTHALMIC PREPARATIONS
acyclovir / hydrocortisonedrugId:1973 - PA DERMATOLOGICAL
acyclovir buccal tabletdrugId:2945 - PA ANTIVIRALS
acyclovir capsule, suspension, tabletdrugId:155 ANTIVIRALS
acyclovir creamdrugId:157 BP - PA ANTIVIRALS
acyclovir injectiondrugId:2744 ANTIVIRALS
acyclovir ointmentdrugId:156 - PA ANTIVIRALS
Aczone (dapsone 5% gel)drugId:325 - PA DERMATOLOGICAL
Aczone (dapsone 7.5% gel)drugId:7306 BP - PA DERMATOLOGICAL
Adacel (diphtheria / tetanus toxoids / acellular pertussis vaccine)drugId:539 1 BIOLOGICAL
Adagen (pegademase bovine)drugId:2682 - PA UNCLASSIFIED DRUG PRODUCTS
Adakveo (crizanlizumab-tmca)drugId:7326 - PA HEMATOLOGIC
AdalatdrugId:1213 # (nifedipine tablet)drugId:1213 CARDIOVASCULAR
adalimumabdrugId:158 PD - PA IMMUNOMODULATOR
adapalene / benzoyl peroxidedrugId:160 - PA DERMATOLOGICAL
adapalenedrugId:159 BP - PA DERMATOLOGICAL
Adcetris (brentuximab)drugId:2374 - PA CHEMOTHERAPY
Adcirca (tadalafil-Adcirca)drugId:1920 - PA CARDIOVASCULAR
Adderall # (amphetamine salts) - PA < 3 years and PA > 90 units/month; See Table 31drugId:60; See Table 71drugId:3100 CEREBRAL STIMULANTS
Adderall XR (amphetamine salts extended-release-Adderall XR) BP PD - PA < 3 years and PA > 60 units/month; See Table 31drugId:59; See Table 71drugId:3000 CEREBRAL STIMULANTS
adefovirdrugId:161 - PA > 30 units/month ANTIVIRALS
Adempas (riociguat)drugId:2883 - PA CARDIOVASCULAR
adenovirus live vaccine delayed-release oral tabletsdrugId:2837 BIOLOGICAL
Adhansia XR (methylphenidate extended-release-Adhansia XR) - PA; See Table 31drugId:7232; See Table 71drugId:7233 CEREBRAL STIMULANTS
Adlyxin (lixisenatide)drugId:5760 - PA DIABETIC AGENTS
Admelog (insulin lispro-Admelog)drugId:6660 - PA DIABETIC AGENTS
ado-trastuzumabdrugId:2781 - PA CHEMOTHERAPY
Adrenalin (epinephrine injection)drugId:606 ADRENERGICS
AdriamycindrugId:571 # (doxorubicin)drugId:571 CHEMOTHERAPY
AdrucildrugId:875 # (fluorouracil injection)drugId:875 CHEMOTHERAPY
Advair (fluticasone / salmeterol inhalation aerosol, powder)drugId:896 - PA BRONCHODILATORS
Advate (antihemophilic factor, recombinant-Advate) ANTI-HEMOPHILIA AGENTS
Adynovate (antihemophilic factor, recombinant pegylated-Adynovate) ANTI-HEMOPHILIA AGENTS
Adzenys ER (amphetamine extended-release 1.25 mg/mL oral suspension) - PA; See Table 31drugId:6600; See Table 71drugId:6601 CEREBRAL STIMULANTS
Adzenys XR-ODT (amphetamine extended-release orally disintegrating tablet) - PA; See Table 31drugId:5360; See Table 71drugId:5361 CEREBRAL STIMULANTS
Aerospan (flunisolide inhalation aerosol)drugId:2920 - PA BRONCHODILATORS
afatinibdrugId:2843 - PA CHEMOTHERAPY
Afinitor (everolimus-Afinitor) BP - PA; See Table 20drugId:448; See Table 57drugId:1954 CHEMOTHERAPY
Afinitor Disperz (everolimus tablets for oral suspension) - PA; See Table 20drugId:6880; See Table 57drugId:2795 CHEMOTHERAPY
Afluria (influenza virus vaccine-Afluria)drugId:2046 1 BIOLOGICAL
Afrezza (insulin human inhalation powder)drugId:4900 - PA DIABETIC AGENTS
Afstyla (antihemophilic factor, recombinant, single chain-Afstyla) ANTI-HEMOPHILIA AGENTS
agalsidase betadrugId:162 - PA ENZYMES
Aggrenox (aspirin / extended-release dipyridamole)drugId:100 BP ANTIPLATELET AGENT
AgrylindrugId:65 # (anagrelide)drugId:65 ANTIPLATELET AGENT
A-HydrocortdrugId:730 # (hydrocortisone injection)drugId:730 GLUCOCORTICOIDS
Aimovig (erenumab-aooe)drugId:6661 - PA BIOLOGICAL
Airduo (fluticasone / salmeterol inhalation powder)drugId:6120 - PA BRONCHODILATORS
Ajovy (fremanezumab-vfrm)drugId:7000 - PA BIOLOGICAL
Akten (lidocaine ophthalmic gel) OPHTHALMIC PREPARATIONS
Akynzeo (fosnetupitant / palonosetron injection)drugId:6620 - PA > 2 vials/28 days ANTIEMETICS
Akynzeo (netupitant / palonosetron capsule)drugId:4761 - PA > 2 capsules/28 days ANTIEMETICS
albendazoledrugId:166 ANTIPARASITICS
AlbenzadrugId:166 # (albendazole)drugId:166 ANTIPARASITICS
albiglutidedrugId:2946 - PA DIABETIC AGENTS
albumin, human solutions PLASMA PROTEINS
albuterol / ipratropium inhalation solutiondrugId:835 BRONCHODILATORS
albuterol / ipratropium inhalation spraydrugId:2557 BRONCHODILATORS
albuterol inhalation powderdrugId:5109 BRONCHODILATORS
albuterol inhalation solutiondrugId:168 BRONCHODILATORS
albuterol inhaler-Proair HFAdrugId:1 BP BRONCHODILATORS
albuterol inhaler-ProventildrugId:2 BRONCHODILATORS
albuterol inhaler-VentolindrugId:3 - PA BRONCHODILATORS
albuterol syrup, tabletdrugId:2193 BRONCHODILATORS
alcaftadinedrugId:2173 - PA ANTIHISTAMINES
alclometasone cream, ointmentdrugId:4 GLUCOCORTICOIDS
AldactazidedrugId:1893 # (spironolactone / hydrochlorothiazide)drugId:1893 CARDIOVASCULAR
AldactonedrugId:1892 # (spironolactone tablet)drugId:1892 ALDOSTERONE ANTAGONISTS
Aldara (imiquimod 5% cream)drugId:783 - PA DERMATOLOGICAL
aldesleukindrugId:2307 CHEMOTHERAPY
Aldurazyme (laronidase)drugId:1026 - PA ENZYMES
Alecensa (alectinib)drugId:5221 - PA CHEMOTHERAPY
alectinibdrugId:5221 - PA CHEMOTHERAPY
alemtuzumab 12 mgdrugId:4782 ^ - PA MULTIPLE SCLEROSIS AGENTS
alemtuzumab 30 mgdrugId:6110 CHEMOTHERAPY
alendronate / cholecalciferoldrugId:9 - PA ELECTROLYTES AND NUTRIENTS
alendronate effervescent tabletdrugId:2638 - PA ELECTROLYTES AND NUTRIENTS
alendronate solutiondrugId:2796 - PA ELECTROLYTES AND NUTRIENTS
alendronate tabletdrugId:7 ELECTROLYTES AND NUTRIENTS
alfuzosin extended-releasedrugId:10 URINARY ANTISPASMODICS
alglucosidase alfadrugId:11 - PA ENZYMES
Align (bifidobacterium infantis)drugId:6200 - PA ≥ 19 years GASTROINTESTINAL AGENT
Alimta (pemetrexed)drugId:1492 CHEMOTHERAPY
Aliqopa (copanlisib)drugId:6500 - PA CHEMOTHERAPY
alirocumabdrugId:5119 - PA LIPID LOWERING AGENTS
aliskiren / hydrochlorothiazidedrugId:14 - PA CARDIOVASCULAR
aliskirendrugId:13 BP - PA CARDIOVASCULAR
alitretinoindrugId:16 - PA CHEMOTHERAPY
AlkerandrugId:1138 # (melphalan hydrochloride injection)drugId:1138 CHEMOTHERAPY
AlkerandrugId:5504 # (melphalan tablet)drugId:5504 CHEMOTHERAPY
allopurinoldrugId:17 GOUT AGENTS
almotriptandrugId:18 - PA TRIPTAN
Alocril (nedocromil)drugId:1180 - PA OPHTHALMIC PREPARATIONS
alogliptin / metformindrugId:2782 - PA DIABETIC AGENTS
alogliptin / pioglitazonedrugId:2783 - PA DIABETIC AGENTS
alogliptindrugId:2784 - PA DIABETIC AGENTS
Alomide (lodoxamide)drugId:1095 - PA OPHTHALMIC PREPARATIONS
AloxidrugId:1473 # (palonosetron 0.25 mg/5 mL injection)drugId:1473 - PA > 2 units/28 days ANTIEMETICS
alpelisibdrugId:7225 - PA CHEMOTHERAPY
alpha-1-proteinase inhibitor, human-Aralast ENZYMES
alpha-1-proteinase inhibitor, human-Aralast NP ENZYMES
alpha-1-proteinase inhibitor, human-Glassia ENZYMES
alpha-1-proteinase inhibitor, human-Prolastin ENZYMES
alpha-1-proteinase inhibitor, human-Zemaira ENZYMES
Alphagan P (brimonidine 0.1%, 0.15% eye drops)drugId:2505 BP OPHTHALMIC PREPARATIONS
Alphanate (antihemophilic factor / von willebrand factor complex, human) ANTI-HEMOPHILIA AGENTS
Alphanine SD (factor IX, human) ANTI-HEMOPHILIA AGENTS
alprazolam extended-release - PA < 6 years and PA > 60 units/month; See Table 69drugId:26; See Table 71drugId:4359 BENZODIAZEPINES
alprazolam orally disintegrating tablet - PA; See Table 69drugId:24; See Table 71drugId:4357 BENZODIAZEPINES
alprazolam - PA < 6 years; See Table 69drugId:25; See Table 71drugId:4358 BENZODIAZEPINES
alprazolam powder - PA; See Table 69drugId:27; See Table 71drugId:4360 BENZODIAZEPINES
Alprolix (factor IX recombinant, Fc fusion protein) ANTI-HEMOPHILIA AGENTS
Alrex (loteprednol 0.2%)drugId:1105 - PA OPHTHALMIC PREPARATIONS
AltacedrugId:2588 # (ramipril)drugId:2588 CARDIOVASCULAR
Altoprev (lovastatin extended-release)drugId:1107 - PA LIPID LOWERING AGENTS
Altreno (tretinoin 0.05% lotion)drugId:6900 - PA DERMATOLOGICAL
aluminum carbonate * GASTROINTESTINAL AGENT
aluminum hydroxidedrugId:28 * ANTACIDS
Alunbrig (brigatinib)drugId:6180 - PA CHEMOTHERAPY
Alvesco (ciclesonide)drugId:230 BRONCHODILATORS
amantadine extended-release capsuledrugId:6402 - PA ANTIPARKINSON
amantadine extended-release tabletdrugId:7006 - PA ANTIPARKINSON
amantadine immediate-release capsule, solution, tabletdrugId:29 ANTIPARKINSON
AmaryldrugId:931 # (glimepiride)drugId:931 DIABETIC AGENTS
Ambien # (zolpidem 10 mg tablet) - PA < 6 years and PA > 30 units/month; See Table 15drugId:1932; See Table 71drugId:4342 SEDATIVES
Ambien # (zolpidem 5 mg tablet) - PA < 6 years and PA > 45 units/month; See Table 15drugId:1933; See Table 71drugId:4344 SEDATIVES
Ambien CR # (zolpidem extended-release tablet) - PA < 6 years and PA > 30 units/month; See Table 15drugId:1934; See Table 71drugId:4345 SEDATIVES
Ambisome (amphotericin B liposome) ANTIBIOTICS
ambrisentandrugId:30 - PA CARDIOVASCULAR
amcinonide creamdrugId:31 - PA GLUCOCORTICOIDS
amcinonide lotiondrugId:4916 GLUCOCORTICOIDS
amcinonide ointmentdrugId:4917 - PA GLUCOCORTICOIDS
Ameluz (aminolevulinic acid) ^ CHEMOTHERAPY
Amerge (naratriptan)drugId:1175 - PA TRIPTAN
Amicar (aminocaproic acid) BP HEMATINIC AGENT
amifampridinedrugId:7041 - PA POTASSIUM CHANNEL BLOCKER
amifostinedrugId:2670 ANTIDOTES
amikacindrugId:32 ANTIBIOTICS
amikacin liposome inhalationdrugId:7040 - PA ANTIBIOTICS
amiloridedrugId:33 CARDIOVASCULAR
amiloride / hydrochlorothiazidedrugId:34 CARDIOVASCULAR
amino acid and electrolyte IV infusion ELECTROLYTES AND NUTRIENTS
aminocaproic acid BP HEMATINIC AGENT
aminolevulinic acid ^ CHEMOTHERAPY
aminosalicylic aciddrugId:2500 TB PREPARATIONS
Amitiza (lubiprostone)drugId:1110 - PA CONSTIPATION AGENTS
amitriptyline / chlordiazepoxidedrugId:40 - PA < 6 years ANTIDEPRESSANTS
amitriptyline / perphenazine - PA < 6 years; See Table 24drugId:6320; See Table 71drugId:1512 ANTIPSYCHOTIC
amitriptyline powder - PA; See Table 17drugId:6368; See Table 71drugId:6369 ANTIDEPRESSANTS
amitriptyline tablet - PA < 6 years; See Table 17drugId:39; See Table 71drugId:4000 ANTIDEPRESSANTS
amlodipinedrugId:41 CARDIOVASCULAR
amlodipine / atorvastatin - PA; See Table 13drugId:42; See Table 18drugId:43 CARDIOVASCULAR/STATIN
amlodipine / benazeprildrugId:44 CARDIOVASCULAR
amlodipine / olmesartan / hydrochlorothiazidedrugId:1969 - PA CARDIOVASCULAR
amlodipine / olmesartandrugId:46 - PA CARDIOVASCULAR
amlodipine / telmisartandrugId:1661 - PA CARDIOVASCULAR
amlodipine / valsartandrugId:48 CARDIOVASCULAR
amlodipine / valsartan / hydrochlorothiazidedrugId:50 - PA CARDIOVASCULAR
amlodipine suspensiondrugId:7260 - PA CARDIOVASCULAR
ammonium lactate DERMATOLOGICAL
Ammonul # (sodium phenylacetate / sodium benzoate) ELECTROLYTES AND NUTRIENTS
amoxapine - PA < 6 years; See Table 17drugId:56; See Table 71drugId:4001 ANTIDEPRESSANTS
amoxicillindrugId:57 ANTIBIOTICS
amoxicillin / clavulanate 125/31.25 mg/5 mL suspensiondrugId:54 - PA ANTIBIOTICS
amoxicillin / clavulanate chewable tablet, 200/28.5, 250/62.5, 400/57, 600/42.9 mg/5 mL suspension, tabletdrugId:6420 ANTIBIOTICS
amoxicillin / clavulanate extended-releasedrugId:55 - PA ANTIBIOTICS
amphetamine extended-release 1.25 mg/mL oral suspension - PA; See Table 31drugId:6600; See Table 71drugId:6601 CEREBRAL STIMULANTS
amphetamine extended-release 2.5 mg/mL oral suspension - PA; See Table 31drugId:5383; See Table 71drugId:5384 CEREBRAL STIMULANTS
amphetamine extended-release orally disintegrating tablet - PA; See Table 31drugId:5360; See Table 71drugId:5361 CEREBRAL STIMULANTS
amphetamine salts extended-release-Adderall XR BP PD - PA < 3 years and PA > 60 units/month; See Table 31drugId:59; See Table 71drugId:3000 CEREBRAL STIMULANTS
amphetamine salts extended-release-Mydayis - PA; See Table 31drugId:6285; See Table 71drugId:6286 CEREBRAL STIMULANTS
amphetamine salts - PA < 3 years and PA > 90 units/month; See Table 31drugId:60; See Table 71drugId:3100 CEREBRAL STIMULANTS
amphetamine sulfate orally disintegrating tablet - PA; See Table 31drugId:7235; See Table 71drugId:7236 CEREBRAL STIMULANTS
amphetamine sulfate - PA; See Table 31drugId:4901; See Table 71drugId:4920 CEREBRAL STIMULANTS
amphotericin B ANTIBIOTICS
amphotericin B lipid complex ANTIBIOTICS
amphotericin B liposome ANTIBIOTICS
ampicillin; See Table 35drugId:63; See Table 66drugId:2623 ANTIBIOTICS
ampicillin / sulbactamdrugId:64 ANTIBIOTICS
Ampyra (dalfampridine)drugId:320 - PA MULTIPLE SCLEROSIS AGENTS
Amrix (cyclobenzaprine extended-release)drugId:304 - PA MUSCLE RELAXANT
Anadrol-50 (oxymetholone) ANABOLIC STEROID
Anafranil (clomipramine) - PA; See Table 17drugId:272; See Table 71drugId:4002 ANTIDEPRESSANTS
anagrelidedrugId:65 ANTIPLATELET AGENT
anakinradrugId:66 - PA IMMUNOMODULATOR
Anascorp (centruroides immune F(ab’)2, equine) ^ ANTIDOTES
anastrozoledrugId:69 CHEMOTHERAPY
AncobondrugId:861 # (flucytosine)drugId:861 ANTIBIOTICS
Androderm (testosterone patch)drugId:1682 - PA HORMONE REPLACEMENT THERAPY
Androgel (testosterone 1.62% gel packet, pump)drugId:2280 - PA HORMONE REPLACEMENT THERAPY
Androgel (testosterone 1% gel packet)drugId:2248 BP - PA HORMONE REPLACEMENT THERAPY
Androxy (fluoxymesterone) ANABOLIC STEROID
Angeliq (estradiol / drospirenone) HORMONE REPLACEMENT THERAPY
anidulafungin ANTIBIOTICS
Annovera (segesterone / ethinyl estradiol) CONTRACEPTIVES
Anoro (umeclidinium / vilanterol)drugId:2952 - PA BRONCHODILATORS
AntabusedrugId:549 # (disulfiram)drugId:549 ALCOHOL AND DRUG CESSATION AGENT
Antara (fenofibrate capsule)drugId:468 LIPID LOWERING AGENTS
antihemophilic factor, human-Humate-P ANTI-HEMOPHILIA AGENTS
antihemophilic factor, human-Koate-DVI ANTI-HEMOPHILIA AGENTS
antihemophilic factor, human-Monoclate-P ANTI-HEMOPHILIA AGENTS
antihemophilic factor, recombinant, porcine sequence-Obizur ANTI-HEMOPHILIA AGENTS
antihemophilic factor, recombinant, single chain-Afstyla ANTI-HEMOPHILIA AGENTS
antihemophilic factor, recombinant-Advate ANTI-HEMOPHILIA AGENTS
antihemophilic factor, recombinant-Helixate ANTI-HEMOPHILIA AGENTS
antihemophilic factor, recombinant-Hemofil-M ANTI-HEMOPHILIA AGENTS
antihemophilic factor, recombinant-Kogenate ANTI-HEMOPHILIA AGENTS
antihemophilic factor, recombinant-Kovaltry ANTI-HEMOPHILIA AGENTS
antihemophilic factor, recombinant-Novoeight ANTI-HEMOPHILIA AGENTS
antihemophilic factor, recombinant-Nuwiq ANTI-HEMOPHILIA AGENTS
antihemophilic factor, recombinant pegylated-Adynovate ANTI-HEMOPHILIA AGENTS
antihemophilic factor, recombinant pegylated-aucl-Jivi ANTI-HEMOPHILIA AGENTS
antihemophilic factor, recombinant-Recombinate ANTI-HEMOPHILIA AGENTS
antihemophilic factor, recombinant-Xyntha ANTI-HEMOPHILIA AGENTS
antihemophilic factor / von willebrand factor complex, human ANTI-HEMOPHILIA AGENTS
anti-inhibitor coagulant complex-Feiba NF ANTI-HEMOPHILIA AGENTS
anti-inhibitor coagulant complex-Feiba VH ANTI-HEMOPHILIA AGENTS
antithymocyte globulin, equinedrugId:1112 BIOLOGICAL
antithymocyte globulin, rabbitdrugId:1111 BIOLOGICAL
Anusol-HCdrugId:740 # (hydrocortisone hemorrhoidal cream)drugId:740 GLUCOCORTICOIDS
Anzemet (dolasetron injection)drugId:558 ANTIEMETICS
Anzemet (dolasetron tablet)drugId:557 - PA ANTIEMETICS
Apadaz (benzhydrocodone / acetaminophen)drugId:7234 - PA OPIOID ANALGESICS
apalutamidedrugId:6682 - PA CHEMOTHERAPY
Apexicon-E (diflorasone cream / emollient)drugId:520 - PA GLUCOCORTICOIDS
Apidra (insulin glulisine)drugId:810 DIABETIC AGENTS
apixabandrugId:2721 - PA ANTICOAGULANTS
Aplenzin (bupropion hydrobromide extended-release) - PA; See Table 17drugId:395; See Table 71drugId:3640 ANTIDEPRESSANTS
Apokyn (apomorphine)drugId:83 ANTIPARKINSON
apomorphinedrugId:83 ANTIPARKINSON
apraclonidinedrugId:84 OPHTHALMIC PREPARATIONS
apremilastdrugId:2941 - PA IMMUNOMODULATOR
aprepitant 125 mg powder for oral suspensiondrugId:5726 - PA > 6 units/28 days ANTIEMETICS
aprepitant 40 mg and 125 mg capsuledrugId:86 - PA > 2 capsules/28 days ANTIEMETICS
aprepitant 80 mgdrugId:85 - PA > 4 capsules/28 days ANTIEMETICS
aprepitant injectable emulsiondrugId:6604 ANTIEMETICS
aprepitant trifold packdrugId:87 BP - PA > 2 packs/28 days ANTIEMETICS
Apriso (mesalamine extended-release)drugId:1150 BP GI ANTI-INFLAMMATORY
Aptensio XR (methylphenidate extended-release-Aptensio XR) - PA; See Table 31drugId:5100; See Table 71drugId:5101 CEREBRAL STIMULANTS
Aptiom (eslicarbazepine) - PA; See Table 20drugId:2953; See Table 71drugId:3380 ANTICONVULSANTS
Aptivus (tipranavir)drugId:1709 ANTIVIRALS
Aquadeks (multivitamins / minerals / coenzyme Q10-Aquadeks)drugId:2380 - PA HEMATINIC AGENT
Aquadeks (multivitamins / minerals / folic acid / coenzyme Q10-Aquadeks)drugId:2385 - PA HEMATINIC AGENT
Aralast (alpha-1-proteinase inhibitor, human-Aralast) ENZYMES
Aralast NP (alpha-1-proteinase inhibitor, human-Aralast NP) ENZYMES
Aranesp (darbepoetin alfa)drugId:327 - PA HEMATINIC AGENT
Arava # (leflunomide) IMMUNOMODULATOR
Arcalyst (rilonacept)drugId:1434 - PA BIOLOGICAL
Arcapta (indacaterol)drugId:2357 - PA BRONCHODILATORS
ArediadrugId:1474 # (pamidronate)drugId:1474 ELECTROLYTES AND NUTRIENTS
arformoteroldrugId:88 - PA BRONCHODILATORS
Aricept (donepezil 23 mg tablet)drugId:2247 - PA ALZHEIMER'S THERAPY
AriceptdrugId:2422 # (donepezil 10 mg tablet)drugId:2422 - PA < 18 years and PA > 60 units/month ALZHEIMER'S THERAPY
AriceptdrugId:559 # (donepezil 5 mg tablet)drugId:559 - PA < 18 years and PA > 30 units/month ALZHEIMER'S THERAPY
Arikayce (amikacin liposome inhalation)drugId:7040 - PA ANTIBIOTICS
ArimidexdrugId:69 # (anastrozole)drugId:69 CHEMOTHERAPY
aripiprazole extended-release injection - PA; See Table 24drugId:2717; See Table 71drugId:4200 ANTIPSYCHOTIC
aripiprazole lauroxil 1,064 mg PD - PA < 6 years and PA > 1 injection/2 months; See Table 24drugId:6300; See Table 71drugId:6301 ANTIPSYCHOTIC
aripiprazole lauroxil 441 mg, 662 mg, 882 mg PD - PA < 6 years and PA > 1 injection/month; See Table 24drugId:5240; See Table 71drugId:5241 ANTIPSYCHOTIC
aripiprazole lauroxil 675 mg PD - PA < 6 years and PA > 1 injection/month; See Table 24drugId:6861; See Table 71drugId:6860 ANTIPSYCHOTIC
aripiprazole orally disintegrating tablet - PA; See Table 24drugId:92; See Table 71drugId:4220 ANTIPSYCHOTIC
aripiprazole solution - PA < 6 years or ≥ 18 years and PA > 750 mL/month; See Table 24drugId:91; See Table 71drugId:4240 ANTIPSYCHOTIC
aripiprazole tablet - PA < 6 years and PA > 30 units/month; See Table 24drugId:90; See Table 71drugId:4180 ANTIPSYCHOTIC
aripiprazole tablet with sensor - PA; See Table 24drugId:7230; See Table 71drugId:7231 ANTIPSYCHOTIC
Aristada (aripiprazole lauroxil 1,064 mg) PD - PA < 6 years and PA > 1 injection/2 months; See Table 24drugId:6300; See Table 71drugId:6301 ANTIPSYCHOTIC
Aristada (aripiprazole lauroxil 441 mg, 662 mg, 882 mg) PD - PA < 6 years and PA > 1 injection/month; See Table 24drugId:5240; See Table 71drugId:5241 ANTIPSYCHOTIC
Aristada Initio (aripiprazole lauroxil 675 mg) PD - PA < 6 years and PA > 1 injection/month; See Table 24drugId:6861; See Table 71drugId:6860 ANTIPSYCHOTIC
Aristospan (triamcinolone injection)drugId:1750 GLUCOCORTICOIDS
ArixtradrugId:904 # (fondaparinux)drugId:904 ANTICOAGULANTS
armodafinildrugId:94 - PA NARCOLEPSY AGENTS
Armonair (fluticasone propionate inhalation powder-Armonair)drugId:6340 - PA BRONCHODILATORS
Arnuity (fluticasone furoate inhalation powder)drugId:4760 - PA BRONCHODILATORS
AromasindrugId:450 # (exemestane)drugId:450 CHEMOTHERAPY
Arranon (nelarabine)drugId:1182 - PA CHEMOTHERAPY
arsenic trioxidedrugId:2697 CHEMOTHERAPY
artemether / lumefantrinedrugId:95 - PA > 24 units/365 days ANTIMALARIALS
ArthrotecdrugId:514 # (diclofenac / misoprostol)drugId:514 - PA < 60 years NONSTEROIDAL ANTI-INFLAMMATORY
Artificial Tears (glycerin / propylene glycol)drugId:678 * OPHTHALMIC PREPARATIONS
Arymo ER (morphine extended-release tablet-Arymo ER)drugId:6040 - PA OPIOID ANALGESICS
Arzerra (ofatumumab)drugId:1270 - PA CHEMOTHERAPY
Asacol HD (mesalamine high dose delayed-release)drugId:1152 BP GI ANTI-INFLAMMATORY
Asceniv (immune globulin IV, human-slra)drugId:7327 - PA BIOLOGICAL
Asclera (polidocanol)drugId:2934 ^ - PA CARDIOVASCULAR
ascorbic aciddrugId:96 * ELECTROLYTES AND NUTRIENTS
ascorbic acid powderdrugId:7339 - PA ELECTROLYTES AND NUTRIENTS
asenapine - PA; See Table 24drugId:97; See Table 71drugId:4260 ANTIPSYCHOTIC
asfotase alfadrugId:5300 - PA ENZYMES
Asmanex HFA (mometasone inhalation aerosol)drugId:5102 BRONCHODILATORS
Asmanex Twisthaler (mometasone 110 mcg inhalation powder)drugId:2663 - PA ≥ 12 years BRONCHODILATORS
Asmanex Twisthaler (mometasone 220 mcg inhalation powder)drugId:1379 - PA < 12 years BRONCHODILATORS
asparaginase erwinia chrysanthemidrugId:2420 ^ - PA CHEMOTHERAPY
Asparlas (calaspargase pegol-mknl)drugId:7328 ^ - PA CHEMOTHERAPY
aspirin / extended-release dipyridamoledrugId:100 BP ANTIPLATELET AGENT
aspirin * ANALGESICS
aspirin with buffers * ANALGESICS
Astagraf XL (tacrolimus extended-release capsule)drugId:2838 IMMUNOMODULATOR
Astepro (azelastine 0.15% nasal spray)drugId:116 - PA NASAL PREPARATIONS
Astramorph-PF (morphine, injection-Astramorph-PF)drugId:1391 - PA > 120 mg/day OPIOID ANALGESICS
Atacand (candesartan)drugId:433 - PA CARDIOVASCULAR
Atacand HCT (candesartan / hydrochlorothiazide)drugId:434 - PA CARDIOVASCULAR
atazanavirdrugId:101 ANTIVIRALS
atazanavir / cobicistatdrugId:4768 ANTIVIRALS
Atelvia (risedronate delayed-release)drugId:2101 - PA ELECTROLYTES AND NUTRIENTS
atenololdrugId:102 CARDIOVASCULAR
atenolol / chlorthalidonedrugId:103 CARDIOVASCULAR
atezolizumabdrugId:5593 - PA CHEMOTHERAPY
Atgam (antithymocyte globulin, equine)drugId:1112 BIOLOGICAL
Ativan # (lorazepam solution, tablet) - PA < 6 years; See Table 69drugId:1100; See Table 71drugId:4400 BENZODIAZEPINES
atomoxetine - PA < 6 years; See Table 31drugId:104; See Table 71drugId:3080 NONSTIMULANT ADHD AGENTS
atorvastatin 10 mg, 20 mg, 40 mgdrugId:105 - PA > 45 units/month LIPID LOWERING AGENTS
atorvastatin 80 mgdrugId:2933 - PA > 30 units/month LIPID LOWERING AGENTS
atovaquonedrugId:106 ANTIPARASITICS
atovaquone / proguanil ANTIMALARIALS
Atralin (tretinoin 0.05% gel)drugId:2432 - PA DERMATOLOGICAL
Atripla (efavirenz / emtricitabine / tenofovir)drugId:591 ANTIVIRALS
Atrovent # (ipratropium nasal spray) NASAL PREPARATIONS
Atrovent HFA (ipratropium inhalation aerosol)drugId:833 BRONCHODILATORS
Aubagio (teriflunomide)drugId:2657 - PA MULTIPLE SCLEROSIS AGENTS
Augmentin (amoxicillin / clavulanate 125/31.25 mg/5 mL suspension)drugId:54 - PA ANTIBIOTICS
AugmentindrugId:6420 # (amoxicillin / clavulanate chewable tablet, 200/28.5, 250/62.5, 400/57, 600/42.9 mg/5 mL suspension, tablet)drugId:6420 ANTIBIOTICS
Augmentin XR (amoxicillin / clavulanate extended-release)drugId:55 - PA ANTIBIOTICS
Auryxia (ferric citrate) ELECTROLYTES AND NUTRIENTS
Austedo (deutetrabenazine)drugId:6121 - PA NEUROLOGIC AGENT
AvalidedrugId:969 # (irbesartan / hydrochlorothiazide)drugId:969 CARDIOVASCULAR
Avandia (rosiglitazone)drugId:1456 - PA DIABETIC AGENTS
AvaprodrugId:968 # (irbesartan)drugId:968 CARDIOVASCULAR
Avastin (bevacizumab)drugId:360 - PA CHEMOTHERAPY
avatrombopagdrugId:6990 - PA HEMATOLOGIC
AVC (sulfanilamide)drugId:1909 ANTIBIOTICS
Aveed (testosterone undecanoate)drugId:2954 ^ - PA HORMONE REPLACEMENT THERAPY
Avelox (moxifloxacin injection)drugId:2748 ANTIBIOTICS
Avelox (moxifloxacin tablet)drugId:1398 - PA ANTIBIOTICS
avelumabdrugId:6100 - PA CHEMOTHERAPY
AvitadrugId:1747 # (tretinoin-Avita)drugId:1747 - PA ≥ 22 years DERMATOLOGICAL
Avodart (dutasteride)drugId:586 - PA BENIGN PROSTATIC HYPERPLASIA AGENTS
Avonex (interferon beta-1a-Avonex)drugId:825 MULTIPLE SCLEROSIS AGENTS
Avycaz (ceftazidime / avibactam)drugId:4902 - PA ANTIBIOTICS
Axert (almotriptan)drugId:18 - PA TRIPTAN
axicabtagene ciloleuceldrugId:6414 CO ^ - PA CHEMOTHERAPY
Axiron (testosterone 2% solution)drugId:2237 - PA HORMONE REPLACEMENT THERAPY
axitinibdrugId:2484 - PA CHEMOTHERAPY
Aygestin (norethindrone 5 mg) HORMONE REPLACEMENT THERAPY
azacitidinedrugId:110 CHEMOTHERAPY
AzactamdrugId:120 # (aztreonam injection)drugId:120 ANTIBIOTICS
Azasite (azithromycin ophthalmic solution)drugId:119 BP - PA OPHTHALMIC PREPARATIONS
azathioprine 50 mg tabletdrugId:111 IMMUNOMODULATOR
azathioprine 75 mg, 100 mg tabletdrugId:2857 - PA IMMUNOMODULATOR
azathioprine injectiondrugId:5501 IMMUNOMODULATOR
Azedra (iobenguane I 131)drugId:6980 ^ CHEMOTHERAPY
azelaic acid creamdrugId:112 - PA DERMATOLOGICAL
azelaic acid foamdrugId:5106 - PA DERMATOLOGICAL
azelaic acid geldrugId:113 BP - PA DERMATOLOGICAL
azelastine / fluticasone propionatedrugId:2580 NASAL PREPARATIONS
azelastine 0.15% nasal spraydrugId:116 - PA NASAL PREPARATIONS
azelastine 137 mcg nasal spraydrugId:115 NASAL PREPARATIONS
azelastine ophthalmic solutiondrugId:114 ANTIHISTAMINES
Azelex (azelaic acid cream)drugId:112 - PA DERMATOLOGICAL
Azilect (rasagiline)drugId:1640 - PA ANTIPARKINSON
azilsartan / chlorthalidonedrugId:2480 - PA CARDIOVASCULAR
azilsartandrugId:2240 - PA CARDIOVASCULAR
azithromycin; See Table 35drugId:117; See Table 66drugId:2622 ANTIBIOTICS
azithromycin ophthalmic solutiondrugId:119 BP - PA OPHTHALMIC PREPARATIONS
Azopt (brinzolamide)drugId:375 - PA OPHTHALMIC PREPARATIONS
Azor (amlodipine / olmesartan)drugId:46 - PA CARDIOVASCULAR
aztreonam injectiondrugId:120 ANTIBIOTICS
AzulfidinedrugId:1910 # (sulfasalazine)drugId:1910 GI ANTI-INFLAMMATORY
Azulfidine EN-TabsdrugId:4864 # (sulfasalazine delayed-release)drugId:4864 GI ANTI-INFLAMMATORY

MassHealth Drug List Footnotes
PA Prior authorization is required. The prescriber must obtain prior authorization for the drug in order for the pharmacy to receive payment. Note: Prior authorization applies to both the brand-name and the FDA "A"-rated generic equivalent of listed product.
# This designates a brand-name drug with FDA “A”-rated generic equivalents. Prior authorization is required for the brand, unless a particular form of that drug (for example, tablet, capsule, or liquid) does not have an FDA “A”-rated generic equivalent.
BP Brand Preferred over generic equivalents. In general, MassHealth requires a trial of the preferred drug or clinical rationale for prescribing the non-preferred drug generic equivalent.
CO Carve-Out. This agent is listed on the Acute Hospital Carve-Out Drugs List and is subject to additional monitoring and billing requirements.
PD Preferred Drug. In general, MassHealth requires a trial of the preferred drug or clinical rationale for prescribing a non-preferred drug within a therapeutic class.
* The generic OTC and, if any, generic prescription versions of the drug are payable under MassHealth without prior authorization.
o Prior-authorization status depends on the drug's formulation.
^ This drug is available through the health care professional who administers the drug. MassHealth does not pay for this drug to be dispensed through a retail pharmacy.
1 Product may be available through the Massachusetts Department of Public Health (DPH). Please check with DPH for availability. MassHealth does not pay for immunizing biologicals (i.e., vaccines) and tubercular (TB) drugs that are available free of charge through local boards of public health or through the Massachusetts Department of Public Health without prior authorization (130 CMR 406.413(C)). In cases where free vaccines are available to providers for specific populations (e.g. children, high risk, etc.), MassHealth will reimburse the provider only for individuals not eligible for the free vaccines. Notwithstanding the above, MassHealth will pay pharmacies for seasonal flu vaccine serum without prior authorization, if the vaccine is administered in the pharmacy.
2 Prior authorization status is gender specific.

Note: Any drug that does not appear on the List requires prior authorization.

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Last updated 02/24/20