| Alinia tablet | No longer covered | nitazoxanide tablet |
| Aptensio XR extended-release capsule | No longer covered | methylphenidate extended-release capsule |
| Atripla tablet | No longer covered | efavirenz/emtricitabine/tenofovir disoproxil tablet |
| Banzel suspension | No longer covered | rufinamide suspension |
| Bethkis inhalation solution | No longer covered | tobramycin inhalation solution |
| Kerydin topical solution | No longer covered | tavaborole topical solution |
| Kuvan powder packet | No longer covered | sapropterin powder packet |
| Kuvan tablet | No longer covered | sapropterin tablet |
| Monurol powder packet | No longer covered | fosfomycin powder packet |
| Sklice lotion | No longer covered | ivermectin lotion |
| Symfi Lo tablet | No longer covered | efavirenz/lamivudine/tenofovir disoproxil tablet |
| Taytulla capsule | No longer covered | norethindrone/ethinyl estradiol capsule |
| Tecfidera delayed-release capsule | No longer covered | dimethyl fumarate delayed-release capsule |
| Truvada 200 mg-300 mg tablet | No longer covered | emtricitabine/tenofovir disoproxil 200 mg-300 mg tablet |
| Tykerb tablet | No longer covered | lapatinib tablet |