Injectable Drug Guidelines

Some injectable drugs must be ordered through specialty pharmacies, which work with Priority Health guidelines on authorization.
See the list of injectable drugs for more details.

Prescribing and authorizing injectable specialty drugs

1. Complete a Priority Health prior authorization form.
   
2. If the drug must be ordered through a specialty pharmacy, fax or call in the medication request to either specialty pharmacy listed below using a fax sheet, provided.
3. The specialty pharmacy reviews the medication request based upon Priority Health guidelines, and Priority Health faxes an approval, denial or request for additional information to you.
4. If applicable, a Patient Care Coordinator (PCC) from the specialty pharmacy contacts you or the patient to arrange for delivery and collection of copayment.
5. The specialty pharmacy sends the injectable order through overnight express delivery to either the patient's home or physician's office, as you request. All necessary supplies such as syringes, needles, alcohol pads, and sharps containers are provided at no extra cost.

Refills
If applicable, a Patient Care Coordinator from the specialty pharmacy will contact the patient or your office about a week before the next scheduled refill to arrange for delivery and copayment.

Accessing Diplomat Specialty Pharmacy  

Address:
214 East Fulton St.
Grand Rapids, MI 49503

Physician orders:
Local:      616 356-6048
Toll-free: 866 356-6048

Physician fax: 
Local:       616 356-6049
Toll-free:  877 356-6048

Fax forms:

• Standard order form (53KB PDF)
• Aranesp, Epogen, Neulasta, Neupogen and Procrit only - HMO, PPO, POS (50KB PDF)
• Copaxone or Rebif only - HMO, PPO, POS (51KB PDF)