Prescription Drug Services
A wide variety of HIV and non-HIV medications are available to eligible HIV+ individuals through Ryan White Program prescription drug services. Only medications included in the most current Ryan White Program Prescription Drug Formulary can be accessed through the Ryan White Program.
The goal of this service is to prolong the lives of persons living with HIV by improving their health through access to life-sustaining medications. This service is available to individuals who are 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.
Additional information on Ryan White prescription drug services appears below:
Prescription Drug Formulary
- Sorted by Brand Name Revised 10/15/2013
- Sorted by Generic Name Revised 10/15/2013
- Sorted by HRSA d-codeRevised 10/15/2013
- Sorted by Pharmacologic Classification 10/15/2013
- Sorted by Therapeutic Classification 10/15/2013
- Notations/Comments Revised 10/15/2013
- Cover Letter Revised 10/29/2013
- Department of Health Memo (Complera)
- Department of Health Memo (Edurant)
- Department of Health Memo (Etravirine)
- Department of Health Memo (Stribild)
- Letter to OMC Providers
- Stribild Info Key Points
- Gilead Sciences-Stribild Indications Warnings
Letters of Medical Necessity (LOMN)
- LOMN - Antiretroviral Assay (Phenotype) (For OMC)
- LOMN - Aptivus
- LOMN - Fuzeon
- LOMN - Neupogen (1/4/2013)
- LOMN - Procrit or Epogen (1/4/2013)
- LOMN - Roxicodone (Oxycodone)
- LOMN - Sporanox
- LOMN - Trofile
- LOMN - Nutritional Supplements Adults - pg1 of 2_physician
- LOMN - Nutritional Supplements Adults - pg2 of 2_dietitian
Request to add or delete medication
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