Drug List Changes

  • Effective November 01, 2016

    Formulary Changes to the Preferred B2 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Apidra vialTaken off the drug listNovolog vial in Tier 2
    Apidra SolostarTaken off the drug listNovolog Flexpen in Tier 2
    Humalog vialTaken off the drug listNovolog vial in Tier 2
    Humalog Mix 50/50 vial and Humalog Mix 75/25 vialTaken off the drug listNovolog Mix 70/30 vial in Tier 2
    Humulin 70/30 vial and Humulin 70/30 KwikpenTaken off the drug listNovolin 70/30 vial in Tier 2
    Humulin N vial and Humulin N KwikpenTaken off the drug listNovolin N vial in Tier 2
    Humulin R vialTaken off the drug listNovolin R vial in Tier 2

    Formulary Changes to the Preferred B3 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Apidra vialMoving to level 3 from level 2Novolog vial in Tier 2
    Apidra SolostarMoving to level 3 from level 2Novolog Flexpen in Tier 2
    Humalog vialMoving to level 3 from level 2Novolog vial in Tier 2
    Humalog Mix 50/50 vial and Humalog Mix 75/25 vialMoving to level 3 from level 2Novolog Mix 70/30 vial in Tier 2
    Humulin 70/30 vial and Humulin 70/30 KwikpenMoving to level 3 from level 2Novolin 70/30 vial in Tier 2
    Humulin N vial and Humulin N KwikpenMoving to level 3 from level 2Novolin N vial in Tier 2
    Humulin R vialMoving to level 3 from level 2Novolin R vial in Tier 2

    Formulary Changes to the Preferred B4 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Apidra vialMoving to level 3 from level 2Novolog vial in Tier 2
    Apidra SolostarMoving to level 3 from level 2Novolog Flexpen in Tier 2
    Humalog vialMoving to level 3 from level 2Novolog vial in Tier 2
    Humalog Mix 50/50 vial and Humalog Mix 75/25 vialMoving to level 3 from level 2Novolog Mix 70/30 vial in Tier 2
    Humulin 70/30 vial and Humulin 70/30 KwikpenMoving to level 3 from level 2Novolin 70/30 vial in Tier 2
    Humulin N vial and Humulin N KwikpenMoving to level 3 from level 2Novolin N vial in Tier 2
    Humulin R vialMoving to level 3 from level 2Novolin R vial in Tier 2

    Formulary Changes to the Value-Based V1 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Alogliptin tabletMoving to level 4 from level 3Januvia tablet or Onglyza tablet in Tier 3
    Alogliptin/metformin tabletMoving to level 4 from level 3Janumet tablet, Janumet XR tablet or Kombiglyze XR tablet in Tier 3
    Alogliptin/pioglitazone tabletMoving to level 4 from level 3Januvia tablet, Janumet tablet, Janumet XR tablet, Kombiglyze tablet or Onglyza tablet in Tier 3
    Apidra vialMoving to level 3 from level 2Novolog vial in Tier 2
    Apidra SolostarMoving to level 3 from level 2Novolog Flexpen in Tier 2
    Glyxambi tabletMoving to level 4 from level 3Januvia tablet, Janumet tablet, Janumet XR tablet, Kombiglyze tablet or Onglyza tablet in Tier 3
    Humalog vialMoving to level 3 from level 2Novolog vial in Tier 2
    Humalog Mix 50/50 vial and Humalog Mix 75/25 vialMoving to level 3 from level 2Novolog Mix 70/30 vial in Tier 2
    Humulin 70/30 vial and Humulin 70/30 KwikpenMoving to level 3 from level 2Novolin 70/30 vial in Tier 2
    Humulin N vial and Humulin N KwikpenMoving to level 3 from level 2Novolin N vial in Tier 2
    Humulin R vialMoving to level 3 from level 2Novolin R vial in Tier 2
    Jentadueto tabletMoving to level 4 from level 3Janumet tablet, Janumet XR tablet or Kombiglyze tablet in Tier 3
    Kazano tabletMoving to level 4 from level 3Janumet tablet, Janumet XR tablet or Kombiglyze tablet in Tier 3
    Oseni tabletMoving to level 4 from level 3Januvia tablet, Janumet tablet, Janumet XR tablet, Kombiglyze tablet or Onglyza tablet in Tier 3
    Tradjenta tabletMoving to level 4 from level 3Januvia tablet, Janumet tablet, Janumet XR tablet, Kombiglyze tablet or Onglyza tablet in Tier 3

    Formulary Changes to the Select C4 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Apidra vialMoving to level 3 from level 2Novolog vial in Tier 2
    Apidra SolostarMoving to level 3 from level 2Novolog Flexpen in Tier 2
    Humalog vialMoving to level 3 from level 2Novolog vial in Tier 2
    Humalog Mix 50/50 vial and Humalog Mix 75/25 vialMoving to level 3 from level 2Novolog Mix 70/30 vial in Tier 2
    Humulin 70/30 vial and Humulin 70/30 KwikpenMoving to level 3 from level 2Novolin 70/30 vial in Tier 2
    Humulin N vial and Humulin N KwikpenMoving to level 3 from level 2Novolin N vial in Tier 2
    Humulin R vialMoving to level 3 from level 2Novolin R vial in Tier 2

    *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.