Preferred Medical Drugs
Horizon BCBSNJ maintains the following medical drugs as part of our Preferred Medical Drug Initiative.
Based on the guidelines within our online Medical Policy Manual, members, in some cases, must first try a preferred drug in the categories below before we will consider a non-preferred medical drug in that category. We strongly encourage you to review the medical policy content for these drugs for full details.
Select a category to review the preferred/non-preferred medical drugs information.
Bone Resorption Inhibitors (osteoporosis)
Colony-Stimulating Factors (Long Acting)
Colony-Stimulating Factors (Short Acting)
Enzyme Replacement Therapy (Gaucher's)
Erythropoiesis-Stimulating Agents
The drugs on this list may be subject to change. This content was last reviewed on January 27, 2023.
This webpage contains prescription brand name drugs that are registered marks or trademarks of pharmaceutical manufacturers that are not affiliated with either Horizon Blue Cross Blue Shield of New Jersey or the Blue Cross Blue Shield Association.
Antiemetics
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Kytril® |
J1626 |
Generic |
Preferred |
Zofran® |
J2405 |
Generic |
Preferred |
Aloxi® |
J2469 |
Helsinn |
Non-preferred |
Sustol® |
J1627 |
Heron |
Non-preferred |
Bendamustines
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Belrapzo® |
J0586 |
Eagle |
Preferred |
Bendeka® |
J0587 |
Teva |
Preferred |
Treanda® |
J0585 |
Cephalon |
Non-preferred |
Vivimusta |
J9999 |
Slayback |
Non-preferred |
Bone Resorption Inhibitors (Osteoporosis)
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Reclast® |
J3489 |
Generic |
Preferred |
Boniva® |
J1740 |
Generic |
Non-preferred |
Forteo® |
J3110 |
Lilly |
Non-preferred |
Prolia® |
J0897 |
Amgen |
Non-preferred |
Botulinum Toxins
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Botox® |
J0585 |
Allergan |
Preferred |
Dysport® |
J0586 |
Ipsen |
Non-preferred |
Myobloc® |
J0587 |
Solstice |
Non-preferred |
Xeomin® |
J0588 |
Merz |
Non-preferred |
Colony-Stimulating Factors (Long Acting)
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Fulphila® |
Q5108 |
Mylan |
Preferred |
Neulasta® |
J2505 |
Amgen |
Preferred |
Udenyca® |
Q5111 |
Coherus |
Preferred |
Fylnetra® |
J3590 |
Amneal |
Non-preferred |
Nyvepria® |
Q5122 |
Pfizer |
Non-preferred |
Fylnetra® |
J3590 |
Amneal |
Non-preferred |
Rolvedon™ |
J3590 |
Spectrum |
Non-preferred |
Stimufend® |
J3590 |
Fresnius Kabi |
Non-preferred |
Ziextenzo™ |
Q5120 |
Sandoz |
Non-preferred |
Colony-Stimulating Factors (Short Acting)
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Granix® |
J1447 |
Teva |
Preferred |
Zarxio® |
Q5101 |
Sandoz |
Preferred |
Neupogen® |
J1442 |
Amgen |
Non-preferred |
Nivestym® |
Q5110 |
Pfizer |
Non-preferred |
Releuko® |
J3590 |
Amneal |
Non-preferred |
Complement Inhibitors – NMOSD
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Ultomiris® |
J1303 |
Alexion |
Preferred |
Soliris® |
J1300 |
Alexion |
Non-preferred |
Uplizna® |
J1823 |
Horizon |
Non-preferred |
Contraceptives
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Kyleena® |
J7296 |
Bayer |
Preferred |
Mirena® |
J7298 |
Bayer |
Preferred |
Skyla® |
J7301 |
Bayer |
Preferred |
Liletta® |
J7297 |
Allergan |
Non-preferred |
Paragard® |
J7300 |
Teva |
Non-preferred |
Enzyme Replacement Therapy (Gaucher's)
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Cerdelga® |
NOC |
Genzyme |
Preferred |
Cerezyme® |
J1786 |
Genzyme |
Preferred |
Elelyso® |
J3060 |
Pfizer |
Non-preferred |
Vpriv® |
J3385 |
Shire |
Non-preferred |
Zavesca® |
NOC |
Actelion |
Non-preferred |
Erythropoiesis-Stimulating Agents
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Retacrit® |
Q5106 |
Pfizer |
Preferred |
Retacrit® (ESRD) |
Q5105 |
Pfizer |
Preferred |
Aranesp® |
J0881 |
Amgen |
Non-preferred |
Aranesp® (ESRD) |
J0882 |
Amgen |
Non-preferred |
Epogen® |
J0885 |
Amgen |
Non-preferred |
Epogen® (ESRD) |
Q4081 |
Amgen |
Non-preferred |
Mircera® |
J0888 |
Roche |
Non-preferred |
Mircera® (ESRD) |
J0887 |
Roche |
Non-preferred |
Procrit® |
J0885 |
Janssen |
Non-preferred |
Procrit® (ESRD) |
Q4081 |
Janssen |
Non-preferred |
Folinic Acids
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Leucovorin® |
J0640 |
Generic |
Preferred |
Fusilev® |
J0641 |
Generic |
Non-preferred |
Khapzory™ |
J0642 |
Acrotech |
Non-preferred |
Generalized Myasthenia Gravis
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Vyvgart |
J9332 |
Argenx |
Preferred |
Ultomiris |
J1303 |
Alexion |
Non-preferred |
Infliximabs
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Avsola™ |
Q5121 |
Amgen |
Preferred |
Inflectra® |
Q5103 |
Pfizer |
Preferred |
Remicade® |
J1745 |
Janssen |
Preferred |
Renflexis® |
Q5104 |
Merck |
Preferred |
Intravenous Immune Globulin
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Bivigam® |
J1556 |
Biotest |
Preferred |
Flebogamma® |
J1572 |
Grifols |
Preferred |
Gammagard® Liquid |
J1569 |
Baxalta |
Preferred |
Gammagard® S/D |
J1566 |
Baxalta |
Preferred |
Gammaked™ |
J1561 |
Kedrion |
Preferred |
Gamunex-C® |
J1561 |
Grifols |
Preferred |
Gammaplex® |
J1557 |
Bio Products |
Preferred |
Octagam® |
J1568 |
Octapharma |
Preferred |
Privigen® |
J1459 |
CSL Behring |
Preferred |
Asceniv™ |
J1554 |
Adma |
Non-preferred |
Iron, Intravenous
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Dexferrum® |
J1750 |
American Reagent |
Preferred |
Feraheme® |
Q0138 |
AMAG |
Preferred |
Feraheme® (ESRD) |
Q0139 |
AMAG |
Preferred |
Ferrlecit® |
J2916 |
Sanofi |
Preferred |
Infed® |
J1750 |
Allergan |
Preferred |
Injectafer® |
J1439 |
American Reagent |
Preferred |
Venofer® |
J1756 |
American Reagent |
Preferred |
Oncology/Bevacizumab
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Mvasi™ |
Q5107 |
Amgen |
Preferred |
Zirabev™ |
Q5118 |
Pfizer |
Preferred |
Alymsys® |
J9999 |
Amneal |
Non-preferred |
Avastin® |
J9035 |
Genentech |
Non-preferred |
Vegzelma® |
J9999 |
Celltrion |
Non-preferred |
Oncology/Rituximab
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Ruxience™ |
Q5119 |
Pfizer |
Preferred |
Truxima® |
Q5115 |
Teva |
Preferred |
Riabni™ |
NOC |
Amgen |
Non-preferred |
Rituxan® |
J9312 |
Genentech |
Non-preferred |
Oncology/Taxanes
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Taxol® |
J9267 |
Generic |
Preferred |
Taxotere® |
J9171 |
Generic |
Preferred |
Abraxane® |
J9264 |
Celgene |
Non-preferred |
Oncology/Trastuzumab
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Kanjinti™ |
Q5117 |
Amgen |
Preferred |
Trazimera™ |
Q5116 |
Pfizer |
Preferred |
Herceptin® |
J9355 |
Genentech |
Non-preferred |
Herzuma® |
Q5113 |
Teva |
Non-preferred |
Ogivri® |
Q5114 |
Mylan |
Non-preferred |
Ontruzant® |
Q5112 |
Merck |
Non-preferred |
Ophthalmic Injections
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Avastin® |
C9257 |
Genentech |
Preferred |
Beovu® |
J0179 |
Novartis |
Preferred |
Eylea® |
J0178 |
Regeneron |
Preferred |
Lucentis® |
J2778 |
Genentech |
Preferred |
Byooviz™ |
Q5124 |
Biogen |
Preferred |
Cimerli™ |
J3590 |
Coherus |
Preferred |
Susvimo™ |
J2779 |
Genentech |
Non-preferred |
Vabysmo™ |
C9097 |
Genentech |
Non-preferred |
Viscosupplementation
Drug Name |
HCPCS |
Manufacturer |
Drug Status |
Euflexxa® |
J7323 |
Ferring |
Preferred |
Monovisc |
J7327 |
Depuy |
Preferred |
Orthovisc® |
J7324 |
Depuy |
Preferred |
Synvisc®/One |
J7325 |
Genzyme |
Preferred |
Durolane® |
J7318 |
Bioventus |
Non-preferred |
Gel-One® |
J7326 |
Zimmer |
Non-preferred |
Gelsyn™-3 |
J7328 |
Bioventus |
Non-preferred |
GenVisc® 850 |
J7320 |
OrthogenRx |
Non-preferred |
Hyalgan® |
J7321 |
Fidia |
Non-preferred |
Hymovi®s |
J7322 |
Fidia |
Non-preferred |
Supartz® |
J7321 |
Bioventus |
Non-preferred |
TriVisc® |
J7329 |
OrthogenRx |
Non-preferred |
Visco-3™ |
J7321 |
Zimmer |
Non-preferred |