- Magellan Rx Management - https://www1.magellanrx.com -

Prior Authorization

We offer a comprehensive range of utilization management programs for high-cost drugs paid under the medical benefit, leveraging advanced technologies and a high-touch, peer-to-peer consultation to ensure appropriate use. Plus, our solutions are flexible and customizable to meet your plan’s unique goals! 

  • We apply appropriate utilization criteria for all medications based on medical evidence  
  • We incorporate genetic testing requirements for applicable drugs  
  • We manage off-label uses through evidence-based research in conjunction with medical policy criteria  
  • We apply step therapy requirements and lab validation for coverage, where appropriate 
  • We have solutions that are designed to achieve optimal outcomes for patients with specific conditions like hemophilia, oncology, and more   
  • We go beyond typical utilization management to develop solutions that optimize dosing and eliminate waste—ask us how

Beyond Prior Authorization

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The power of integration

Ask us how we can develop targeted solutions to optimize appropriate use, adherence, and cost management for high-cost specialty drugs on the medical benefit.