Drug List Changes

  • Effective April 01, 2018

    Formulary Changes to the Preferred B2 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Coreg CR capsuleNo longer coveredcarvedilol controlled-release capsule
    Emend capsuleNo longer coveredaprepitant capsule
    Estrace 0.01% creamNo longer coveredestradiol 0.01% cream
    Lexiva tabletNo longer coveredfosamprenavir tablet
    Reyataz capsuleNo longer coveredatazanavir capsule
    Sustiva capsuleNo longer coveredefavirenz capsule
    Viread tabletNo longer coveredtenofovir disoproxil tablet
    Ziagen solutionNo longer coveredabacavir solution

    Formulary Changes to the Preferred B3 and B4 Drug Lists

    Drug Name Description of Change Cost-effective Alternatives*
    Coreg CR capsuleMoving to a higher levelcarvedilol controlled-release capsule
    Emend capsuleMoving to a higher levelaprepitant capsule
    Estrace 0.01% creamMoving to a higher levelestradiol 0.01% cream
    Lexiva tabletMoving to a higher levelfosamprenavir tablet
    Reyataz capsuleMoving to a higher levelatazanavir capsule
    Sustiva capsuleMoving to a higher levelefavirenz capsule
    Viread tabletMoving to a higher leveltenofovir disoproxil tablet
    Ziagen solutionMoving to a higher levelabacavir solution

    Formulary Changes to the E1 and E4 Drug Lists

    Drug Name Description of Change Cost-effective Alternatives*
    Emend capsuleMoving to a higher levelaprepitant capsule
    Estrace 0.01% creamMoving to a higher levelestradiol 0.01% cream
    Lexiva tabletMoving to a higher levelfosamprenavir tablet
    Reyataz capsuleMoving to a higher levelatazanavir capsule
    Sustiva capsuleMoving to a higher levelefavirenz capsule
    Viread tabletMoving to a higher leveltenofovir disoproxil tablet
    Ziagen solutionMoving to a higher levelabacavir solution

    Formulary Changes to the M1, M2 and M4 Drug Lists

    Drug Name Description of Change Cost-effective Alternatives*
    Aczone 5% topical gelNo longer covereddapsone 5% topical gel
    Buphenyl tabletNo longer coveredsodium phenylbutyrate tablet
    Coreg CR capsuleNo longer coveredcarvedilol controlled-release capsule
    Emend capsuleNo longer coveredaprepitant capsule
    Estrace 0.01% creamNo longer coveredestradiol 0.01% cream
    Lexiva tabletNo longer coveredfosamprenavir tablet
    Reyataz capsuleNo longer coveredatazanavir capsule
    Sabril tabletNo longer coveredvigabatrin tablet
    Sustiva capsuleNo longer coveredefavirenz capsule
    Testim 1% gelNo longer coveredtestosterone 1% gel
    Viread tabletNo longer coveredtenofovir disoproxil tablet
    Vogelxo 1% gelNo longer coveredtestosterone 1% gel

    Formulary Changes to the Select C4 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Estrace 0.01% creamMoving to a higher levelestradiol 0.01% cream
    Lexiva tabletMoving to a higher levelfosamprenavir tablet
    Reyataz capsuleMoving to a higher levelatazanavir capsule
    Sustiva capsuleMoving to a higher levelefavirenz capsule
    Viread tabletMoving to a higher leveltenofovir disoproxil tablet
    Ziagen solutionMoving to a higher levelabacavir solution

    Formulary Changes to the Value-Based V1 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Aczone 5% topical gelMoving to a higher leveldapsone 5% topical gel
    Buphenyl tabletMoving to a higher levelsodium phenylbutyrate tablet
    CellCept tabletMoving to a higher levelmycophenolate mofetil tablet
    Coreg CR capsuleMoving to a higher levelcarvedilol controlled-release capsule
    Donnatal elixirMoving to a higher levelphenobarbital/hyoscyamine/atropine/scopolamine elixir
    Emend capsuleMoving to a higher levelaprepitant capsule
    Estrace 0.01% creamMoving to a higher levelestradiol 0.01% cream
    Istalol eye dropsMoving to a higher leveltimolol eye drops
    Lexiva tabletMoving to a higher levelfosamprenavir tablet
    Retin-A Micro 0.04% gelMoving to a higher leveltretinoin 0.04% gel
    Reyataz capsuleMoving to a higher levelatazanavir capsule
    Sustiva capsuleMoving to a higher levelefavirenz capsule
    Testim 1% gelMoving to a higher leveltestosterone 1% gel
    Viread tabletMoving to a higher leveltenofovir disoproxil tablet
    Vogelxo 1% gelMoving to a higher leveltestosterone 1% gel
    Ziagen solutionMoving to a higher levelabacavir solution

    *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.