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
gabapentin capsule, solution, tablet - PA < 6 years; See Table 20drugId:917; See Table 71drugId:3480	ANTICONVULSANTS
gabapentin enacarbildrugId:2285 - PA	GABA ANALOGS
gabapentin extended-releasedrugId:2366 - PA	GABA ANALOGS
gabapentin powder - PA; See Table 71drugId:6373; See Table 72drugId:6372	ANTICONVULSANTS
Gabitril (tiagabine) - PA; See Table 20drugId:2617; See Table 71drugId:4500	ANTICONVULSANTS
Gablofen (baclofen injection)drugId:2166	MUSCLE RELAXANT
galantamine extended-release capsuledrugId:919 - PA < 18 years and PA > 30 units/month	ALZHEIMER'S THERAPY
galantamine solutiondrugId:2251 - PA	ALZHEIMER'S THERAPY
galantamine tabletdrugId:920 - PA < 18 years and PA > 60 units/month	ALZHEIMER'S THERAPY
galsulfasedrugId:921 - PA	ENZYMES
Gamastan S/D (immune globulin IM, human-Gamastan S/D)drugId:2683 - PA	BIOLOGICAL
Gammagard (immune globulin injection, human-Gammagard)drugId:2198 - PA	BIOLOGICAL
Gammagard S/D (immune globulin IV, human-Gammagard S/D)drugId:787 - PA	BIOLOGICAL
Gammaked (immune globulin injection, human-Gammaked)drugId:2641 - PA	BIOLOGICAL
Gammaplex (immune globulin IV, human-Gammaplex)drugId:2381 - PA	BIOLOGICAL
Gamunex-C (immune globulin injection, human-Gamunex-C)drugId:2167 - PA	BIOLOGICAL
ganciclovir injectiondrugId:922	ANTIVIRALS
ganciclovir ophthalmic gel	OPHTHALMIC PREPARATIONS
Gardasil (human papillomavirus quadrivalent vaccine)drugId:714 1 - PA < 9 years and PA ≥ 27 years	BIOLOGICAL
Gardasil 9 (human papillomavirus 9-valent vaccine)drugId:4770 1 - PA < 9 years and PA ≥ 27 years	BIOLOGICAL
Gastrocrom # (cromolyn oral)	BRONCHODILATORS
gatifloxacin ophthalmic solutiondrugId:1976 - PA	OPHTHALMIC PREPARATIONS
Gattex (teduglutide injection)drugId:2722 - PA	GASTROINTESTINAL AGENT
Gazyva (obinutuzumab)drugId:2887 - PA	CHEMOTHERAPY
gefitinibdrugId:924 - PA	CHEMOTHERAPY
gelatin	COMPOUNDING AGENT
Gelnique (oxybutynin gel)drugId:1315 - PA	URINARY ANTISPASMODICS
Gel-One (crossed-linked hyaluronate)drugId:4802 - PA; Non-Drug Product	NON-DRUG PRODUCT
Gelsyn (hyaluronate-Gelsyn)drugId:5620 - PA; Non-Drug Product	NON-DRUG PRODUCT
gemcitabinedrugId:926	CHEMOTHERAPY
gemfibrozildrugId:927	LIPID LOWERING AGENTS
gemtuzumab ozogamicindrugId:6342 - PA	CHEMOTHERAPY
GemzardrugId:926 # (gemcitabine)drugId:926	CHEMOTHERAPY
Genotropin (somatropin-Genotropin)drugId:1880 PD - PA	HORMONE AGENTS
gentamicin / prednisolone ophthalmic ointment, suspensiondrugId:929 - PA	OPHTHALMIC PREPARATIONS
gentamicin injectiondrugId:2636	ANTIBIOTICS
gentamicin ophthalmic ointment, solutiondrugId:928	OPHTHALMIC PREPARATIONS
gentamicin topical cream, ointmentdrugId:5901	ANTIBIOTICS
Genvisc (hyaluronate-Genvisc)drugId:5340 - PA; Non-Drug Product	NON-DRUG PRODUCT
Genvoya (elvitegravir / cobicistat / emtricitabine / tenofovir alafenamide)drugId:5250 PD	ANTIVIRALS
Geodon (ziprasidone injection)drugId:1925	ANTIPSYCHOTIC
Geodon # (ziprasidone capsule) - PA < 6 years and PA > 60 units/month; See Table 24drugId:1926; See Table 71drugId:4290	ANTIPSYCHOTIC
Giazo (balsalazide 1.1 gram tablet)drugId:2723 - PA	GI ANTI-INFLAMMATORY
Gilenya (fingolimod)drugId:2102 - PA	MULTIPLE SCLEROSIS AGENTS
Gilotrif (afatinib)drugId:2843 - PA	CHEMOTHERAPY
Glassia (alpha-1-proteinase inhibitor, human-Glassia)	ENZYMES
glatiramer 20 mgdrugId:930 BP	MULTIPLE SCLEROSIS AGENTS
glatiramer 40 mgdrugId:6840	MULTIPLE SCLEROSIS AGENTS
glecaprevir / pibrentasvirdrugId:6360 PD - PA	ANTIVIRALS
Gleevec (imatinib)drugId:779 BP	CHEMOTHERAPY
glimepiridedrugId:931	DIABETIC AGENTS
glimepiride / pioglitazonedrugId:1535 - PA	DIABETIC AGENTS
glipizidedrugId:932	DIABETIC AGENTS
glipizide / metformindrugId:935	DIABETIC AGENTS
glipizide extended-releasedrugId:933	DIABETIC AGENTS
glucagon	DIABETIC AGENTS
GlucophagedrugId:1158 # (metformin)drugId:1158	DIABETIC AGENTS
Glucophage XRdrugId:1159 # (metformin extended-release-Glucophage XR)drugId:1159	DIABETIC AGENTS
glucose productsdrugId:6745 - PA ≥ 19 years	DIABETIC AGENTS
GlucotroldrugId:932 # (glipizide)drugId:932	DIABETIC AGENTS
Glucotrol XLdrugId:933 # (glipizide extended-release)drugId:933	DIABETIC AGENTS
GlucovancedrugId:676 # (glyburide / metformin)drugId:676	DIABETIC AGENTS
Glumetza (metformin extended-release-Glumetza)drugId:2987 - PA	DIABETIC AGENTS
glyburidedrugId:674	DIABETIC AGENTS
glyburide, micronizeddrugId:675	DIABETIC AGENTS
glyburide / metformindrugId:676	DIABETIC AGENTS
glycerin / propylene glycoldrugId:678 *	OPHTHALMIC PREPARATIONS
glycerin *	COMPOUNDING AGENT
glycerol phenylbutyratedrugId:2789 - PA	ENZYMES
glycopyrrolate / formoteroldrugId:5700 - PA	BRONCHODILATORS
glycopyrrolate 1.5 mg tabletdrugId:2888 - PA	ANTISPASMODICS,ANTICHOLINERGIC
glycopyrrolate 1 mg tabletdrugId:679	ANTISPASMODICS,ANTICHOLINERGIC
glycopyrrolate 2 mg tabletdrugId:2908	ANTISPASMODICS,ANTICHOLINERGIC
glycopyrrolate inhalation powderdrugId:5393 - PA > 1 inhaler/month	BRONCHODILATORS
glycopyrrolate inhalation solutiondrugId:6742 - PA	BRONCHODILATORS
glycopyrrolate injectiondrugId:5940 - PA	ANTISPASMODICS,ANTICHOLINERGIC
glycopyrrolate oral solutiondrugId:2163 - PA	ANTISPASMODICS,ANTICHOLINERGIC
GlynasedrugId:675 # (glyburide, micronized)drugId:675	DIABETIC AGENTS
GlysetdrugId:1356 # (miglitol)drugId:1356	DIABETIC AGENTS
Glyxambi (empagliflozin / linagliptin)drugId:4771 - PA	DIABETIC AGENTS
Gocovri (amantadine extended-release capsule)drugId:6402 - PA	ANTIPARKINSON
gold sodium thiomalate	IMMUNOMODULATOR
golimumab for infusiondrugId:2850 - PA	IMMUNOMODULATOR
golimumabdrugId:681 - PA	IMMUNOMODULATOR
GolytelydrugId:1549 # (polyethylene glycol-electrolyte solution-Golytely)drugId:1549	LAXATIVES
Golytely packet (polyethylene glycol-electrolyte solution-Golytely packet)drugId:2540	LAXATIVES
Gonitro (nitroglycerin sublingual powder)drugId:5722 - PA	CARDIOVASCULAR
goserelindrugId:682 - PA	CHEMOTHERAPY
Gralise (gabapentin extended-release)drugId:2366 - PA	GABA ANALOGS
granisetron extended-release injectiondrugId:5767 - PA > 2 units/28 days	ANTIEMETICS
granisetron injectiondrugId:683	ANTIEMETICS
granisetron tabletdrugId:684 - PA	ANTIEMETICS
granisetron transdermal systemdrugId:685 - PA	ANTIEMETICS
Granix (TBO-filgrastim)drugId:2889 - PA	HEMATINIC AGENT
grass pollen allergen extractdrugId:4789 - PA	ALLERGENS
Grifulvin VdrugId:687 # (griseofulvin 500 mg tablet)drugId:687	ANTIBIOTICS
griseofulvin 125 mg, 250 mg tabletdrugId:686	ANTIBIOTICS
griseofulvin 500 mg tabletdrugId:687	ANTIBIOTICS
griseofulvin suspensiondrugId:2306	ANTIBIOTICS
Gris-PegdrugId:686 # (griseofulvin 125 mg, 250 mg tablet)drugId:686	ANTIBIOTICS
guanabenz	CARDIOVASCULAR
guanfacine extended-release - PA < 3 years; See Table 31drugId:692; See Table 71drugId:3082	NONSTIMULANT ADHD AGENTS
guanfacine - PA < 3 years; See Table 18drugId:5162; See Table 71drugId:691	CARDIOVASCULAR
guanidine	PARASYMPATHETIC AGENTS
guselkumabdrugId:6289 - PA	IMMUNOMODULATOR
Gynazole-1 (butoconazole)	ANTIBIOTICS

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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.
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 01/22/19