Drug List Changes

  • Effective April 01, 2019

    Formulary Changes to the Preferred B2 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Albenza tabletNo longer coveredalbendazole tablet
    Amicar tabletNo longer coveredaminocaproic acid tablet
    Androgel gel packetNo longer coveredtestosterone gel packet
    Canasa suppositoryNo longer coveredmesalamine suppository
    Elidel topical creamNo longer coveredpimecrolimus topical cream
    Finacea topical gelNo longer coveredazelaic acid topical gel
    Zytiga tabletNo longer coveredabiraterone acetate tablet

    Formulary Changes to the Preferred B3 and B4 Drug Lists

    Drug Name Description of Change Cost-effective Alternatives*
    Albenza tabletMoving to a higher levelalbendazole tablet
    Amicar tabletMoving to a higher levelaminocaproic acid tablet
    Androgel gel packetMoving to a higher leveltestosterone gel packet
    Canasa suppositoryMoving to a higher levelmesalamine suppository
    Elidel topical creamMoving to a higher levelpimecrolimus topical cream
    Finacea topical gelMoving to a higher levelazelaic acid topical gel
    Zytiga tabletMoving to a higher levelabiraterone acetate tablet

    Formulary Changes to the E4 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Androgel gel packetMoving to a higher leveltestosterone gel packet
    Zytiga tabletMoving to a higher levelabiraterone acetate tablet

    Formulary Changes to the M1, M2 and M4 (2019) Drug Lists

    Drug Name Description of Change Cost-effective Alternatives*
    Albenza tabletNo longer coveredalbendazole tablet
    Amicar tabletNo longer coveredaminocaproic acid tablet
    Ampyra extended-release tabletNo longer covereddalfampridine extended-release tablet
    Androgel gel packetNo longer coveredtestosterone gel packet
    Butrans patchNo longer coveredbuprenorphine patch
    Canasa suppositoryNo longer coveredmesalamine suppository
    Elidel topical creamNo longer coveredpimecrolimus topical cream
    Evekeo tabletNo longer coveredamphetamine tablet
    Finacea topical gelNo longer coveredazelaic acid topical gel
    Fortesta topical gelNo longer coveredtestosterone topical gel
    Onfi suspensionNo longer coveredclobazam suspension
    Onfi tabletNo longer coveredclobazam tablet
    Rapaflo capsuleNo longer coveredsilodosin capsule
    Zytiga tabletNo longer coveredabiraterone acetate tablet

    Formulary Changes to the M1, M2 and M4 (2018) Drug Lists

    Drug Name Description of Change Cost-effective Alternatives*
    Albenza tabletNo longer coveredalbendazole tablet
    Amicar tabletNo longer coveredaminocaproic acid tablet
    Ampyra extended-release tabletNo longer covereddalfampridine extended-release tablet
    Androgel gel packetNo longer coveredtestosterone gel packet
    Butrans patchNo longer coveredbuprenorphine patch
    Canasa suppositoryNo longer coveredmesalamine suppository
    Elidel topical creamNo longer coveredpimecrolimus topical cream
    Evekeo tabletNo longer coveredamphetamine tablet
    Finacea topical gelNo longer coveredazelaic acid topical gel
    Fortesta topical gelNo longer coveredtestosterone topical gel
    Onfi suspensionNo longer coveredclobazam suspension
    Onfi tabletNo longer coveredclobazam tablet
    Rapaflo capsuleNo longer coveredsilodosin capsule
    Zytiga tabletNo longer coveredabiraterone acetate tablet

    Formulary Changes to the Select C4 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Amicar tabletMoving to a higher levelaminocaproic acid tablet
    Zytiga tabletMoving to a higher levelabiraterone acetate 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.