Prescription Drug Services

Medications are available to improve the health of individuals living with HIV by gaining access to life-sustaining treatments.

This service is available to persons ineligible to receive medications under any other source, including but not limited to Medicare, Medicaid, the State AIDS Drug Assistance Program (ADAP), private insurance, etc.

Only medications included in the most current Ryan White Program Prescription Drug Formulary can be accessed through the Ryan White Program.

Prescription Drug Formulary

• Prescription Drug Formulary Transmittal Letter (Revised 08/30/21)
• Attachment A – Notations/Comments (Revised 08/30/2021)
• Attachment B – Consumable Medical Supplies List (Revised 04/05/21)
• Prescription Drug Formulary - Sorted by Brand Name (Revised 08/30/21)
• Prescription Drug Formulary - Sorted by Generic Name (Revised 08/30/21)
• Prescription Drug Formulary - Sorted by Pharmacy Classification (Revised 08/30/21)
• Prescription Drug Formulary - Sorted by RW Miami Pharma-Code (Revised 08/30/21)
• Prescription Drug Formulary - Sorted by Therapeutic Classification (Revised 08/30/21)
• Department of Health Memo (Complera)
• Department of Health Memo (Descovy)
• Department of Health Memo (Edurant)
• Department of Health Memo (Etravirine)
• Department of Health Memo (Evotaz)
• Department of Health Email (Juluca)
• Department of Health Memo (Odefsey)
• Department of Health Memo (Prezcobix)
• Department of Health Memo (Tybost)
• Department of Health Memo (Stribild)
• Department of Health Email (Symtuza and Dovato)
• Department of Health Memo (Tivicay)
• Department of Health E-mail (Triumeq)
• Letter to OMC Providers
• Stribild Info Key Points
• Gilead Sciences-Stribild Indications Warnings

Letters of Medical Necessity (LOMN)

• Letter of Medical Necessity Changes for RWP (Part A) Transmittal (7/20/21)
• Neupogen (revised 4/12/21)
• Procrit or Epogen (revised 4/12/21)
• Roxycodone (Oxycodone) (revised 4/12/21)
• Standards for Use of Controlled Substances - for use with Oxycodone LOMN (2/21/19)
• Highly Sensitive Tropism Assay required to prescribe Maraviroc (Selzentry)  (revised 4/12/21)

Request to add or delete medication

• Prescription Drug Formulary Request