Member Pharmacy Benefits

Formulary search tool

You now have the ability to search for drugs using our new Formulary search tool. Searches can be performed by drug name or by drug class. The tool will provide formulary status, generic alternatives and if there are any clinical edits (Prior Authorization, Quantity Limits, Age Limits etc), 

Note:  Effective 6/1/2016, Aetna Better Health of MI will be transitioning to Michigan's Commn Drug Formulary.  For further information, click here.  

You can download the formulary (Michigan Medicaid Formulary). You can also view a list of this month's formulary updates below.

Pharmacy Billing Information

Aetna Better Health of MI members may use the following information along with the ID number to process prescriptions at network pharmacies:

  • BIN: 610591
  • PCN: ADV
  • GROUP: RX8826

Pharmacy providers may go to CVS/Caremark for payer sheets and additional network or processing information.

Enero 2020

Additions:

  • Nubeqa 300 Mg Tablet (Prior Authorization Required)
  • Steglujan 5-100 Mg Tablet (Prior Authorization Required)
  • Steglujan 15-100 Mg Tablet (Prior Authorization Required)
  • Vyndamax 61 Mg Capsule (Prior Authorization Required, Quantity Level Limit)
  • Vyndaqel 20 Mg Capsule (Prior Authorization Required, Quantity Level Limit)
  • Dulera 100 Mcg/5 Mcg Inhaler (Age Limit, Quantity Level Limit)
  • Dulera 200 Mcg/5 Mcg Inhaler (Age Limit, Quantity Level Limit)
  • Mesalamine Dr 1.2 Gm Tablet (Quantity Level Limit, Step Therapy Required)
  • Motegrity 1 Mg Tablet (Prior Authorization Required, Quantity Level Limit)
  • Motegrity 2 Mg Tablet (Prior Authorization Required, Quantity Level Limit)
  • Trospium Chloride Er 60 Mg Cap (Step Therapy Required)
  • Lucemyra 0.18 Mg Tablet (Prior Authorization Required, Quantity Level Limit)
  • Dantrolene Sodium 25 Mg Cap (Quantity Level Limit)
  • Dantrolene Sodium 50 Mg Cap (Quantity Level Limit)
  • Dantrolene Sodium 100 Mg Cap (Quantity Level Limit)
  • Xpovio 80 Mg Twice Weekly Dose (Prior Authorization Required)
  • Xpovio 100 Mg Once Weekly Dose (Prior Authorization Required)
  • Xpovio 80 Mg Once Weekly Dose (Prior Authorization Required)
  • Xpovio 60 Mg Once Weekly Dose (Prior Authorization Required)
  • Trulicity 0.75 Mg/0.5 Ml Pen (Prior Authorization Required, Quantity Level Limit)
  • Trulicity 1.5 Mg/0.5 Ml Pen (Prior Authorization Required, Quantity Level Limit)
  • Albuterol Sulfate Inhal Aero 108 Mcg/ACT

Removals:

  • Ninguna

Other Updates:

  • Mesalamine Tab Delayed Release 800 Mg (Updated Step Therapy Requirements)
  • Mesalamine Cap Dr 400 Mg (Updated Step Therapy Requirements)
  • Mesalamine Cap Sr 24hr 0.375 Gm (Updated Step Therapy Requirements)
  • Mesalamine Cap Cr 250 Mg (Updated Step Therapy Requirements)
  • Mesalamine Cap Cr 500 Mg (Updated Step Therapy Requirements)
  • Trospium Chloride Tab 20 Mg (Updated Step Therapy Requirements)
  • Tolterodine Tartrate Tab 1 Mg (Updated Step Therapy Requirements)
  • Tolterodine Tartrate Tab 2 Mg (Updated Step Therapy Requirements)
  • Tolterodine Tartrate Cap Sr 24hr 2 Mg (Updated Step Therapy Requirements)
  • Tolterodine Tartrate Cap Sr 24hr 4 Mg (Updated Step Therapy Requirements)
  • Enbrel 50 Mg/Ml Sureclick (Changed Quantity Level Limit)
  • Enbrel 50 Mg/Ml Syringe (Changed Quantity Level Limit)

 

Diciembre 2019

Additions:

  • Ninguna

Removals:

  • Bacmin Tab
  • B-Complex Cap
  • Calc/Vit D3 Chw Disney
  • Calciferol Dro 8000/Ml
  • Corvite Free Tab
  • Diabets Hlth Tab Formula
  • Fiber Pow
  • Kelp/Lec/B6 Cap
  • K-Pax Tab Prof St
  • Land Bfr Tim Chw Vit/C
  • Metafolbic Tab Plus
  • Mg-Plus Tab 133mg
  • Multivit/Ped Dro Pls Zinc
  • Nutricap Tab
  • One-A-Day Tab Menopaus
  • Procerv Hp Tab
  • Prorenal+D Tab
  • Repel Family Aer 15%
  • Repel Sports Lot 40%
  • S.S. Tonic Tab
  • Siderol Tab
  • Sm Vit B1 Tab 100mg
  • Strovite One Tab
  • Strovite Tab Forte
  • Tri-Vi-Floro Sus 0.25/Ml
  • Tri-Vi-Floro Sus 0.5mg/Ml
  • Vitacel Tab
  • Vitamax Ped Dro
  • Vitamin B-1 Tab 100mg
  • Vitamin B-1 Tab 50mg
  • Vitamin B-6 Tab 100mg
  • Vitamin B-6 Tab 25mg
  • Vitamin B-6 Tab 50mg
  • Vite/Iron Chw Children

Other Updates:

  • Ninguna

 

November 2019

Additions:

  • Ninguna

Removals:

  • Alka Seltzer Tab Heartbrn
  • Animi-3 Cap Vit D
  • Antacid Extr Chw 675-135
  • Antacid Mult Chw-Symptom
  • Antacid Ultr Chw 1000-200
  • Apetigen Tab Plus
  • Benefiber Chw/Calcium
  • Berocca Tab
  • Biovol Syp
  • Bone Density Tab
  • Bone Essenti Cap
  • Ca Citrate Tab 250mg
  • Ca Gluconate Tab 50mg
  • Ca Lactate Tab 100mg
  • Cal/Mag Tab Chew
  • Calc 600+D3 Cap 600-500
  • Calc Chewabl Chw 600 Plus
  • Calc Citrate Tab +D
  • Calc/Magnes Tab 500-250
  • Calc/Vit D3 Chw 200-200
  • Cal-Citrate Tab Plus D
  • Calcium 1000 Tab + D
  • Calcium 500 Tab
  • Calcium 600 Chw W/Vit D
  • Calcium Carb Pow
  • Calcium Carb Pow 800/2gm
  • Calcium Chw Gummies
  • Calcium Cit/ Tab Vit D
  • Calcium Gra Citrate
  • Calcium Tab Formula
  • Calcium Tab Magnesiu
  • Calcium/Vitd Cap 600-400
  • Calcium+D3 Tab Grad Rel
  • Calmag Thins Tab 200-50mg
  • Cal-Quick Liq 500-400
  • Caltrate 600 Chw 600-800
  • Carbonyl Tab Fe 45mg
  • Ceo-Two Sup
  • Chelated Ca Tab 200mg
  • Citracal+D3 Chw 250-500
  • Coral Calciu Cap
  • Coral Calciu Cap 1000mg
  • Coral Calciu Cap Plus
  • Coral Cap Calcium
  • Culturelle Chw
  • Cvs Antacid Sus Supreme
  • Dewees Carmi Liq
  • D-Natural-5 Cap
  • Docusol Kids Ene 100mg/5m
  • Epsom Salt Gra
  • Eql Calcium Cap Vit D
  • Equalactin Chw 625mg
  • Evzio Inj .4/0.4ml
  • Eye Drops Dro 0.25%
  • E-Z-Gas Ii Gra
  • Ferrous Fum Tab 29mg
  • Fiber Choice Chw 1.5gm
  • Fiber Powder Pow
  • Fiber Weight Chw Manageme
  • Fleet Ene Ped
  • Gentamicin Pow Sulfate
  • Glucose Chw 4gm
  • Honey Bears Chw Iron-Zin
  • Hydrocil Ins Pow 95%
  • Iron 21/7 Mis
  • Iron Tab 18mg
  • Iron Tab 28mg
  • Iron Up Liq
  • Iro-Plex Liq
  • Kelp/Lec/B6 Cap
  • Kondremul Emu 50%
  • Konsyl Daily Pow 100%
  • Kp Mens Mis Daily Pk
  • Liq Ca/Vit D Cap 600mg
  • Liquid Calci Cap With D3
  • Localnesium Tab
  • Localnesium Tab -C
  • Magdelay Tab 64mg
  • Maxfe Tab
  • Metamucil Pow 28%
  • Metamucil Pow 58.12%
  • Metamucil Waf
  • Mult Mineral Tab
  • Mvw Complete Dro Pediatri
  • Nat Fiber Pow 58.6%
  • Novaferrum Cap 50mg
  • Novaferrum Dro 15mg/Ml
  • Novaferrum Liq 125
  • Nutrisource Can Fiber
  • Nutrisource Pkt Fiber
  • Osteo-Poreti Tab
  • Parva-Cal Tab 250-100
  • Parva-Cal Tab 500mg
  • Pedia-Lax Chw 400mg
  • Ph Milk Magn Chw 311mg
  • Poly-Vi-Sol Dro /Iron
  • Prelief Tab
  • Prilosec Otc Tab 20mg
  • Proferrin Es Tab 12 Mg
  • Ra Ca/Boron Tab
  • Ra Coral Cap Calcium
  • Ra Iron Tab 27mg
  • Ra Oys Shl/D Tab 250mg
  • Refresh Liqu Dro 1% Op
  • Repel Family Aer 15%
  • Repel Sports Lot 40%
  • Replesta Waf 50000unt
  • Rx Support Tab Heartbur
  • Scooby-Doo Chw
  • Senna Leaves Mis
  • Slow Iron Tab 50mg
  • Sm Ca/Mg/Zn Tab
  • Super B-Comp Tab Iron/C
  • Super Cal/ Tab Mag
  • Titralac Chw 420mg
  • Udamin Sp Tab
  • Ultra Man Tab
  • Upcal D Pow
  • Upcal D Pow
  • Vitafol Tab (Caplet)
  • Vitamin B-2 Tab 25mg
  • Vitamin D3 Chw 5000unit
  • Vitron-C Tab 65-125
  • Wal-Mucil Cap Plus Ca
  • Ze-Plus Cap

Other Updates:

  • Ninguna

 

October 2019

Additions:

  • Krintafel 150mg Tablet (Prior Authorization Required, Quantity Level Limit)
  • Spiriva Respimat 1.25mcg Inh (Prior Authorization Required, Quantity Level Limit)
  • Symjepi 0.3mg/0.3ml Syringe (Quantity Level Limit)
  • Tretinoin 0.025% Cream (Quantity Level Limit, Step Therapy)

Removals:

  • Ciprofloxacin HCl 100 Mg Tab
  • Econazole Nitrate 1% Cream
  • Norethindrone & Mestranol Tab 1mg-50mcg
  • Tetracycline 250mg Capsule
  • Tetracycline 500mg Capsule

Other Updates:

  • Adefovir Dipivoxil 10mg Tab (Added Quantity Level Limit)
  • Entecavir 0.5mg Tablet (Added Quantity Level Limit)
  • Entecavir 1mg Tablet (Added Quantity Level Limit)
  • Lamivudine 100mg Tablet (Added Quantity Level Limit)

 

September 2019

Additions:

  • Febuxostat Tab (Quantity Level Limit, Prior Authorization)

Removals:

  • Uloric Tab

Other Updates:

  • Ninguna

 

Agosto 2019

Additions:

  • Butenafine HCl Cream 1%

Removals:

  • Ninguna

Other Updates:

  • Ciclopirox Olamine Cream 0.77% (Added Step Therapy)

 

July 2019

Additions:

  • Actemra 162 Mg/0.9 Ml Syringe (Quantity Level Limit, Prior Authorization Required)
  • Actemra Actpen 162 Mg/0.9 Ml (Quantity Level Limit, Prior Authorization Required)
  • Aimovig 140 Mg/Ml Autoinjector (Quantity Level Limit, Prior Authorization Required)
  • Cimzia 200 Mg Vial Kit (Quantity Level Limit, Prior Authorization Required)
  • Cimzia 200 Mg/Ml Starter Kit (Quantity Level Limit, Prior Authorization Required)
  • Cimzia 200 Mg/Ml Syringe Kit (Quantity Level Limit, Prior Authorization Required)
  • Orencia 50 Mg/0.4 Ml Syringe (Quantity Level Limit, Prior Authorization Required)
  • Orencia 87.5 Mg/0.7 Ml Syringe (Quantity Level Limit, Prior Authorization Required)
  • Orencia 125 Mg/Ml Syringe (Quantity Level Limit, Prior Authorization Required)
  • Orencia Clickject 125 Mg/Ml (Quantity Level Limit, Prior Authorization Required)
  • Siliq 210 Mg/1.5 Ml Syringe (Quantity Level Limit, Prior Authorization Required)
  • Xeljanz 10 Mg Tablet (Quantity Level Limit, Prior Authorization Required)
  • Xeljanz 5 Mg Tablet (Quantity Level Limit, Prior Authorization Required)
  • Xeljanz Xr 11 Mg Tablet (Quantity Level Limit, Prior Authorization Required)

Removals:

  • Captopril 100 Mg Tablet
  • Captopril 12.5 Mg Tablet
  • Captopril 25 Mg Tablet
  • Captopril 50 Mg Tablet
  • Dextromethorphan-Guaifenesin 10-100/5ml
  • Guaifenesin Syrup 100 Mg/5ml
  • Hydrocortisone Val 0.2% Cream
  • Pediatric Multiple Vitamin W/ Minerals & C
  • Polyethylene Glycol 3350 Oral Packet
  • Tekturna Hct 150-12.5 Mg Tablet
  • Tekturna Hct 150-25 Mg Tablet
  • Tekturna Hct 300-12.5 Mg Tablet
  • Tekturna Hct 300-25 Mg Tablet

Other Updates:

  • Azelastine Hcl 0.05% Drops (Added Step Therapy)
  • Entresto 24 Mg-26 Mg Tablet (Removed Prior Authorization, Added Age Minimum, Added Step Therapy, Added Quantity Level Limit)
  • Entresto 49 Mg-51 Mg Tablet (Removed Prior Authorization, Added Age Minimum, Added Step Therapy, Added Quantity Level Limit)
  • Entresto 97 Mg-103 Mg Tablet (Removed Prior Authorization, Added Age Minimum, Added Step Therapy, Added Quantity Level Limit)
  • Lidocaine 4% Cream (Added Quantity Level Limit)

 

June 2019

Additions:

  • Docosanol Cream 10%

Removals:

  • Abreva Cream 10%
  • Dextromethorphan-Guaifenesin 10-100/5ml
  • Guaifenesin Syrup 100 Mg/5ml
  • Pediatric Multiple Vitamin W/ Minerals & C

Other Updates:

  • Ninguna

 

Mayo 2019

Additions:

  • Nivestym Inj (Prior Authorization Required)
  • Ranolazine Tab 1000mg ER (Prior Authorization Required)
  • Aliskiren Tab (Quantity Level Limit, Prior Authorization Required)

Removals:

  • Ranexa Tab 1000mg ER
  • Tekturna Tab

Other Updates:

  • Ninguna

 

April 2019

Additions:

  • Aimovig Sol 70mg (Prior Authorization, Quantity Level Limit)
  • Bevespi Aero 9-4.8mcg (Step Therapy)
  • Daurismo Tab 25mg, 100mg (Prior Authorization)
  • Fluticasone-Salmeterol Aero 100-50mcg, 250/50mcg, 500/50mcg (Prior Authorization)
  • Fulphila Syr 6mg (Prior Authorization)
  • Granix Vial 300mcg, 480mcg (Prior Authorization)
  • Humalog Vial 100 Unit (Prior Authorization, Quantity Level Limit)
  • Olumiant Tab 2mg (Prior Authorization, Quantity Level Limit)
  • Ranolazine Tab ER 500mg
  • Sevelamer Tab 400mg, 800mg (Prior Authorization)
  • Symbicort Inh 160-4.5mcg (Age Limit, Quantity Level Limit)
  • Venclexta Tab 10mg, 50mg, 100mg/ Venclexta Starter Pack (Prior Authorization)
  • Xyrem Sol 500mg/mL (Prior Authorization, Quantity Level Limit)

Removals:

  • Advair Diskus 100/50mcg, 250/50mcg, 500/50mcg
  • Amantadine Tab 100mg
  • Fenoprofen Tab 600mg
  • Hydroxyzine Cap 100mg
  • Ranexa ER Tab 500mg
  • Ranitidine Cap 150mg, 300mg
  • Renagel Tab 400mg, 800mg
  • Xarelto Tab 2.5mg

Other Updates:

  • Bromocriptine Cap 5mg (Quantity Level Limit added)
  • Carbidopa-Levodopa Tab 25-100mg ODT (Quantity Level Limit removed)
  • Dalfampridine ER Tab 10mg (Quantity Level Limit added)
  • Imiquimod Crm 5% (Prior Authorization removed)
  • Rivastigmine Cap 1.5mg, 3mg, 4.5mg, 6mg (Quantity Level Limit added)

 

Marzo 2019

Additions:

  • Cinacalcet HCL 30mg, 60mg, 90mg Tab (Prior Authorization, Quantity Level Limit)
  • Pimecrolimus 1% Crm (Prior Authorization, Quantity Level Limit)
  • Toremifene Citrate 60mg Tab (Prior Authorization)

Removals:

  • Elidel 1% Crm
  • Fareston 60mg Tab
  • Sensipar 30mg, 60mg, 90mg Tab

 

Febrero 2019

Removals:

  • Fluticasone Prop Aer Pow 100mcg, 250mcg, 50mcg
  • Trulicity Inj 0.75mg/0.5mL, 1.5mg/0.5mL

Other Updates:

  • Flovent HFA 44mcg, 110mcg, 220mcg (Age Limit added)
  • Lansoprazole Susp 3mg/mL (Age Limit added)

 

Enero 2019

Additions:

  • Erleada 60mg Tab (Prior Authorization, Quantity Level Limit)
  • Ozempic Dose Pen (Quantity Level Limit, Step Therapy)
  • Pertzye DR 8,000U, 16,000U, 24,000U Caps (Quantity Level Limit)
  • Tibsovo 250mg Tab (Prior Authorization, Quantity Level Limit)
  • Viokace Tabs (Quantity Level Limit)
  • Xarelto Starter Pack (Prior Authorization, Quantity Level Limit)
  • Zytiga 500mg Tab (Prior Authorization, Quantity Level Limit)

Removals:

  • Diphenoxylat-Atropine 2.5-0.025/5mg/5mL Liquid
  • Humulin R 500u Kwikpen
  • Tanzeum Pen Injector

Other Updates:

  • Afinitor 7.5mg, 10mg Tab (Quantity Level Limit)
  • Alogliptin Tabs (Prior Authorization removed, Quantity Level Limit, Step Therapy added)
  • Alogliptin-Metformin Tabs (Prior Authorization removed, Quantity Level Limit, Step Therapy added)
  • Alogliptin-Pioglitazone Tabs (Prior Authorization removed, Step Therapy added)
  • Chlorzoxazone 500mg Tab (Age Limit)
  • Cyclobenazprine 5mg, 10mg Tabs (Age Limit)
  • Eliquis Starter Pack (Quantity Level Limit, Age Limit)
  • Eliquis Tabs (Quantity Level Limit, Age Limit)
  • Estradiol Patches (Age Limit)
  • Estradiol-Noreth 0.5-0.1mg, 1-0.5mg Tabs (Age Limit)
  • Menest Tabs (Age Limit)
  • Methocarbamol 500mg, 750mg Tabs (Age Limit)
  • Norethind-Eth Estradiol 0.5-2.5mcg (Quantity Level Limit, Age Limit)
  • Norethind-Eth Estradiol 1mg-5mcg (Age Limit)
  • Orphenadrine ER 100mg Tab (Age Limit)
  • Premphase 0.625-5mg Tab (Age Limit)
  • Prempro Tabs (Age Limit)
  • Tizanidine HCL Tabs (Age Limit)
  • Xarelto 10mg, 15mg, 20mg Tabs (Quantity Level Limit, Age Limit)

Medicamentos con receta are often an important part of your health care. As an Aetna Better Health of Michigan member, you have the right to certain prescription drug benefits.

Aetna Better Health of Michigan covers prescription drugs and certain over – the – counter drugs when presented with a prescription at a pharmacy.

To find out it if a drug that you take is covered, you can check our formulary. A formulary is a list of drugs that Aetna Better Health covers. You can use the prescription drug search tool to find out if a drug is covered. You may also request a printed copy of this formulary by calling Member Services. If you have any questions about a drug that is not listed, please call Member Services toll-free at 1-866-316-3784 (TTY 711), 24 hours a day, 7 days a week.

If a drug is not listed on the formulary, a Pharmacy Prior Authorization Request form must be completed. Your doctor will complete this form. They must show why a formulary drug will not work for you. They must include any medical records needed for the request.

The Pharmacy Prior Authorization form is available on our website. Your doctor may make a request by telephone at 1-866-316-3784 or via fax 1-855-799-2551.

Aetna Better Health of Michigan Members must have their prescriptions filled at a in network pharmacy to have their prescriptions covered at no cost to them. You may go to our website to search for an in-network pharmacy near your zip code.

Prior authorization process:

Aetna Better Health of Michigan's pharmacy prior authorization (PA) process is designed to approve drugs that are medically needed. We require doctors to obtain a PA before prescribing or giving out the following:

  • Injectable drugs provided by a pharmacy
  • Non-formulary drugs that are not excluded under a State’s Medicaid program
  • Prescriptions that do not follow our guidelines (like quantity limits, age limits or step therapy)
  • Brand name drugs, when a generic is available

Aetna Better Health of Michigan's Medical Director decides if a drug is denied or approved using our guidelines. The Medical Director may need additional information before making a decision. This information may include the following:

  • Drugs on the formulary have been tried and does not work (i.e., step therapy)
  • No other drugs on the formulary would work as well as the drug requested
  • The request is acceptable by the Federal Drug Administration (FDA) or is accepted by nationally noted experts
  • For brand name drug requests, a completed FDA MedWatch form documenting failure or issues with the generic equal is required.

Both parties will be told of the decision through the telephone or mail.

Aetna Better Health of Michigan will fill prescriptions for a seventy-two (72) hour supply if the member is waiting for a decision by the Plan.

Step therapy and quantity limits:

The step therapy program requires certain drugs, such as generic drugs or formulary brand drugs to be prescribed before a specific second-line drugs is approved. Drugs having step therapy are listed on the formulary with "STEP". Certain drugs on the Aetna Better Health of Michigan formulary have quantity limits and are listed on the formulary with "QLL"

The QLLs are based on FDA-approved doses and on nationally noted guidelines.

Your doctor can request an override step therapy and/or a quantity limit. They can fax a Pharmacy Prior Authorization Request form with medical records to 1-855-799-2551.

CVS Caremark Specialty Pharmacy:

Los medicamentos especiales de Aetna Better Health son suministrados por CVS Health Specialty Pharmacy. Una farmacia especializada suministra medicamentos pero también tiene otros servicios para ofrecerle. El programa de medicamentos especiales tiene servicios especiales para usted:

  • Puede hablar con un farmacéutico las 24 horas del día, los siete días de la semana
  • También a través de CVS hay información específica de la enfermedad y orientación
  • Coordinación de la atención médica para usted y su médico
  • En cualquier ubicación de CVS Pharmacy hay entrega y retiro de medicamentos especializados para usted, su hogar o el consultorio de su médico (incluidas las que están en las tiendas Target*)

Puede comunicarse con CVS Specialty Pharmacy al 1-800-237-2767; TTY/TDD: 1-800-863-5488 de 7:30 a.m. (EST) hasta 9:00 p.m. (EST), de lunes a viernes. CVS Specialty Pharmacy le ayudará a obtener su medicamento especializado. La lista de medicamentos especializados está aquí.

Preguntas frecuentes

Mail order prescriptions:

Aetna Better Health of Michigan offers mail order prescription services through CVS Caremark. Use one of the following to request this service:

  • Call CVS Caremark, toll free at 1-800-552-8159/TTY 711, Monday to Friday between 8 a.m. and 8 p.m., for help to sign up for mail order service. CVS Caremark will call the prescribing provider to get the prescription with the member's ok.
  • Go online:
  • Log in and sign up for mail service online. If the member gives an ok, CVS Caremark will call the prescribing provider to get the prescription.
  • By requesting your doctor to write a prescription for a 90-day supply with up to one year of refills. CVS Caremark will mail a mail service order form. When the member receives the form, the member fills it out and mails CVS Caremark the prescription and the order form. Forms should be mailed to:

 CVS CAREMARK

PO BOX 94467

               PALATINE, IL 60094-4467