Workers Compensation Pharmaceuticals: Prior Authorization and Brand to Generic Guidebook

2021 Edition

The intent of this guidebook is to provide a resource for claims professionals that provides easy access to information on medications that have been rejected and provides possible alternatives to the rejected medications. The guidebook also provides the most common indication for each medication when used in the workers’ compensation population. A list of medications that should be considered prior to the rejected medication (step therapy) is presented, along with a supporting rationale.

For 2021 we have added the “Brand to Generic Reference Guide: Workers’ Compensation Pharmaceuticals,” previously a separate document, as a reference section to this guide. This resource provides information on some of the most commonly prescribed medications in workers’ compensation with a focus on generic availability. Some products may no longer be available as a result of discontinuations, and some new products may have been added after this guide was published. This guide is solely for reference purposes and not intended and should not be used nor relied upon for purposes of prescribing or using a product. The trademarks and other product names listed in this guide are the property of their respective companies.

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