Fenofibrate (brand and generic name) 200 mg capsules Fenofibrate is used to treat high cholesterol and high triglyceride levels.
Fenofibrate is requested to treat mixed hyperlipidemia. The enrollee tried and failed Lipitor and fish oil.
Fenofibrate is a generic drug on Tier 4 of the Plan's formulary. There were no available lower tier 3 generic drugs on the Plan’s formulary to treat the enrollee’s condition. Therefore, Fenofibrate was not eligible for a tiering exception. The prescriber did not submit documentation showing that the lower tier drug(s) would not be as effective for the enrollee as the higher tier drug(s), and/or would cause adverse effects.
Fenofibrate is requested to treat mixed hyperlipidemia. The enrollee tried and failed Lipitor and fish oil.
Fenofibrate is a generic drug on Tier 4 of the Plan's formulary. There were no available lower tier 3 generic drugs on the Plan’s formulary to treat the enrollee’s condition. Therefore, Fenofibrate was not eligible for a tiering exception. The prescriber did not submit documentation showing that the lower tier drug(s) would not be as effective for the enrollee as the higher tier drug(s), and/or would cause adverse effects.