Drug List Changes

  • Effective January 01, 2017

    Formulary Changes to the Preferred B2 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Benicar tabletNo longer coveredolmesartan tablet
    Benicar HCT tabletNo longer coveredolmesartan/hydrochlorothiazide tablet
    Beyaz tabletNo longer covereddrospirenone/ethinyl estradiol/levomefolate tablet
    Epzicom tabletNo longer coveredabacavir sulfate/lamivudine tablet
    Fenoglide tabletNo longer coveredfenofibrate tablet
    Nilandron tabletNo longer coverednilutamide tablet
    Nitrostat sublingual tabletNo longer coverednitroglycerin sublingual tablet

    Formulary Changes to the Preferred B3 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Benicar tabletMoving to a higher levelolmesartan tablet
    Benicar HCT tabletMoving to a higher levelolmesartan/hydrochlorothiazide tablet
    Beyaz tabletMoving to a higher leveldrospirenone/ethinyl estradiol/levomefolate tablet
    Epzicom tabletMoving to a higher levelabacavir sulfate/lamivudine tablet
    Fenoglide tabletMoving to a higher levelfenofibrate tablet
    Nilandron tabletMoving to a higher levelnilutamide tablet
    Nitrostat sublingual tabletMoving to a higher levelnitroglycerin sublingual tablet

    Formulary Changes to the Preferred B4 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Benicar tabletMoving to a higher levelolmesartan tablet
    Benicar HCT tabletMoving to a higher levelolmesartan/hydrochlorothiazide tablet
    Beyaz tabletMoving to a higher leveldrospirenone/ethinyl estradiol/levomefolate tablet
    Epzicom tabletMoving to a higher levelabacavir sulfate/lamivudine tablet
    Fenoglide tabletMoving to a higher levelfenofibrate tablet
    Nilandron tabletMoving to a higher levelnilutamide tablet
    Nitrostat sublingual tabletMoving to a higher levelnitroglycerin sublingual tablet

    Formulary Changes to the X1 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Benicar tabletNo longer coveredolmesartan tablet
    Benicar HCT tabletNo longer coveredolmesartan/hydrochlorothiazide tablet
    Beyaz tabletNo longer covereddrospirenone/ethinyl estradiol/levomefolate tablet
    Cordran topical lotionNo longer coveredflurandrenolide topical lotion
    Epzicom tabletNo longer coveredabacavir sulfate/lamivudine tablet
    Fenoglide tabletNo longer coveredfenofibrate tablet
    Nilandron tabletNo longer coverednilutamide tablet
    Nitrostat sublingual tabletNo longer coverednitroglycerin sublingual tablet
    Vagifem tabletNo longer coveredestradiol tablet
    Valcyte oral solutionNo longer coveredvalganciclovir oral solution

    Formulary Changes to the X3 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Benicar tabletNo longer coveredolmesartan tablet
    Benicar HCT tabletNo longer coveredolmesartan/hydrochlorothiazide tablet
    Beyaz tabletNo longer covereddrospirenone/ethinyl estradiol/levomefolate tablet
    Cordran topical lotionNo longer coveredflurandrenolide topical lotion
    Epzicom tabletNo longer coveredabacavir sulfate/lamivudine tablet
    Fenoglide tabletNo longer coveredfenofibrate tablet
    Nilandron tabletNo longer coverednilutamide tablet
    Nitrostat sublingual tabletNo longer coverednitroglycerin sublingual tablet
    Vagifem tabletNo longer coveredestradiol tablet
    Valcyte oral solutionNo longer coveredvalganciclovir oral solution

    Formulary Changes to the X4 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Apidra vialMoving to a higher levelNovolog vial
    Apidra SolostarMoving to a higher levelNovolog Flexpen
    Benicar tabletNo longer coveredolmesartan tablet
    Benicar HCT tabletNo longer coveredolmesartan/hydrochlorothiazide tablet
    Beyaz tabletNo longer covereddrospirenone/ethinyl estradiol/levomefolate tablet
    Cordran topical lotionNo longer coveredflurandrenolide topical lotion
    Epzicom tabletNo longer coveredabacavir sulfate/lamivudine tablet
    Fenoglide tabletNo longer coveredfenofibrate tablet
    Humalog vialMoving to a higher levelNovolog vial
    Humalog Mix 50/50 vialMoving to a higher levelNovolog Mix 70/30 vial
    Humalog Mix 75/25 vialMoving to a higher levelNovolog Mix 70/30 vial
    Humulin 70/30 vialMoving to a higher levelNovolin 70/30 vial
    Humulin 70/30 KwikpenMoving to a higher levelNovolin 70/30 vial
    Humulin N vialMoving to a higher levelNovolin N vial
    Humulin N KwikpenMoving to a higher levelNovolin N vial
    Humulin R vialMoving to a higher levelNovolin R vial
    Nilandron tabletNo longer coverednilutamide tablet
    Nitrostat sublingual tabletNo longer coverednitroglycerin sublingual tablet
    Vagifem tabletNo longer coveredestradiol tablet
    Valcyte oral solutionNo longer coveredvalganciclovir oral solution

    Formulary Changes to the Value-Based V1 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Azor tabletMoving to a higher levelamlodipine/olmesartan tablet
    Beyaz tabletMoving to a higher leveldrospirenone/ethinyl estradiol/levomefolate tablet
    Cordran topical lotionMoving to a higher levelflurandrenolide topical lotion
    Epzicom tabletMoving to a higher levelabacavir sulfate/lamivudine tablet
    Fenoglide tabletMoving to a higher levelfenofibrate tablet
    Nilandron tablet Moving to a higher levelnilutamide tablet
    Nitrostat sublingual tabletMoving to a higher levelnitroglycerin sublingual tablet
    Tribenzor tabletMoving to a higher levelamlodipine/olmesartan/hydrochlorothiazide tablet
    Vagifem tabletMoving to a higher levelestradiol tablet

    Formulary Changes to the Select C4 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Epzicom tabletMoving to a higher levelabacavir sulfate/lamivudine tablet
    Nilandron tabletMoving to a higher levelnilutamide 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.