Increlex® (mecasermin)

For further information on medical drugs, please see the Injectable drugs page.

Priority Health Medicaid no longer utilizes drug-specific prior authorization forms for drugs covered under the pharmacy benefit.

Visit the Approved Drug List (ADL) to search by drug name and view the criteria and PA form.

Go to Medicaid ADL

Code(s): J2170

Benefit: Pharmacy

Notes: Treatment of insulin-like growth factor-1 deficiency

Length of authorization: 12 months