Drug coverage is limited to prescription products approved by the Food and Drug Administration as evidenced by a New Drug Application (NDA), Abbreviated New Drug Application (ANDA), or Biologics Licensed Application (BLA) on file. Any legal requirements or group specific benefits for coverage will supersede this (e.g. preventive drugs per the Affordable Care Act).


Drug coverage may also be subject to policy guidelines established by Blue Cross and Blue Shield of Alabama. Drug coverage policies are not intended to dictate to physicians how to practice medicine. Physicians should exercise their medical judgment in providing the care they feel is most appropriate for their patients.


Please note: Some employer groups may have specific drug coverage requirements for their employees that are not included in the criteria below.

Drug Coverage Guidelines

Search by Drug Name

Product Name Guideline Coverage Benefit* Implementation Date Change Date
EDARBI® Edarbi may be subject to step therapy requirements. Patients must have trial and failure of a generic ACE inhibitor or generic ARB. P 04/01/11 10/01/15
EDARBYCLOR® Edarbyclor may be subject to step therapy requirements. Patients must have trial and failure of a generic ACE inhibitor or generic ARB. P 07/01/12 10/01/15
EDEX® Prior authorization for medical necessity may be required. Patients must be at least 18 years of age. P 07/01/10
EDLUAR® The limits are 1 tablet per day. P 07/06/09 07/01/13
EDURANT The limits are 1 tablet per day. P 07/01/12
EFFEXOR The limits are 3 tablets per day. P 10/01/16
EFFEXOR XR® The limits are 1 capsule per day, except Effexor XR 75mg which has a limit of 3 capsules per day. P 07/01/05 02/13/08
EFINACONAZOLE Prior authorization for medical necessity is required. The limits are 4ml per 30 days. P 07/01/16
EFUDEX Prior Authorization is required for medical necessity. The limits will vary based on the disease being treated. P 10/01/16
ELAPRASE Prior authorization for medical necessity is required. M 07/01/18
ELELYSO Prior authorization for medical necessity is required. M 07/01/18
ELESTRIN The limits are 1 pump per 30 days. P 04/01/19
ELIDEL® Elidel may be subject to step therapy requirements. Patients must have trial and failure of a topical corticosteriod or topical corticosteroid combination preparation. P 10/01/18
ELIQUIS The limits are 2 tablets per day for Eliquis 2.5mg and 4 tablets per day for Eliqus 5 mg. P 07/01/13 10/01/14
ELMIRON Prior authorization is required for medical necessity. P 04/01/19