Drug List Changes

  • Effective April 01, 2021

    Formulary Changes to the Preferred B3 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Atripla tabletMoving to Tier 3efavirenz/emtricitabine/tenofovir disoproxil tablet
    Banzel suspensionMoving to Tier 3rufinamide suspension
    Tecfidera delayed-release capsuleMoving to Tier 3dimethyl fumarate delayed-release capsule
    Truvada 200 mg-300 mg tabletMoving to Tier 3emtricitabine/tenofovir disoproxil 200 mg-300 mg tablet
    Tykerb tabletMoving to Tier 3lapatinib tablet

    Formulary Changes to the Preferred B4 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Atripla tabletMoving to Tier 3efavirenz/emtricitabine/tenofovir disoproxil tablet
    Banzel suspensionMoving to Tier 3rufinamide suspension
    Truvada 200 mg-300 mg tabletMoving to Tier 3emtricitabine/tenofovir disoproxil 200 mg-300 mg tablet

    Formulary Changes to the E4 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Symfi tabletMoving to Tier 4efavirenz/lamivudine/tenofovir disoproxil tablet
    Symfi Lo tabletMoving to Tier 4efavirenz/lamivudine/tenofovir disoproxil tablet
    Tecfidera delayed-release capsuleMoving to Tier 4dimethyl fumarate delayed-release capsule
    Truvada 200 mg-300 mg tabletMoving to Tier 4emtricitabine/tenofovir disoproxil 200 mg-300 mg tablet

    Formulary Changes to the M1, M2 and M4 Drug Lists

    Drug Name Description of Change Cost-effective Alternatives*
    Alinia tabletNo longer coverednitazoxanide tablet
    Aptensio XR extended-release capsuleNo longer coveredmethylphenidate extended-release capsule
    Atripla tabletNo longer coveredefavirenz/emtricitabine/tenofovir disoproxil tablet
    Banzel suspensionNo longer coveredrufinamide suspension
    Bethkis inhalation solutionNo longer coveredtobramycin inhalation solution
    Kerydin topical solutionNo longer coveredtavaborole topical solution
    Kuvan powder packetNo longer coveredsapropterin powder packet
    Kuvan tabletNo longer coveredsapropterin tablet
    Monurol powder packetNo longer coveredfosfomycin powder packet
    Sklice lotionNo longer coveredivermectin lotion
    Symfi Lo tabletNo longer coveredefavirenz/lamivudine/tenofovir disoproxil tablet
    Taytulla capsuleNo longer coverednorethindrone/ethinyl estradiol capsule
    Tecfidera delayed-release capsuleNo longer covereddimethyl fumarate delayed-release capsule
    Truvada 200 mg-300 mg tabletNo longer coveredemtricitabine/tenofovir disoproxil 200 mg-300 mg tablet
    Tykerb tabletNo longer coveredlapatinib tablet

    *These drugs have been selected by an independent group of experts made up of doctors and pharmacists. This group reviews drugs to see how well they work relative to their cost. They also compare their effectiveness to similar drugs used to treat the same condition. Please talk with your doctor to see if these new options are right for you.