Change to EmblemHealth’s Compounded Drug Coverage, Effective November 15, 2014

Date Issued: 10/1/2014

Effective November 15, 2014, EmblemHealth will no longer cover certain compounded drugs.*

Click on the link below to see a list of the most frequently prescribed excluded compounded drugs and their commercially available, FDA-approved alternatives. Please prescribe these commercially available medications when possible.

This coverage decision was made for the following reasons:

  • The ingredients used to make certain compounded medications are not approved by the Food and Drug Administration (FDA).
  • The effectiveness of certain compounded medications has not been proven.
  • The safety and quality of certain compounded medications has not been evaluated.

Top 25 Excluded Compounded Drugs* and Commercially Available Alternatives

*The FDA defines a compounded drug as one that requires a licensed pharmacist to combine, mix or alter the ingredients of a medication when filling a prescription. Compounded drugs, unlike FDA-approved medications, often lack the rigorous clinical studies to validate safety and effectiveness.

Policy & Alerts