Drug List Changes

  • Effective January 01, 2019

    Formulary Changes to the Preferred B2 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Asacol HD 800 mg tabletNo longer coveredmesalamine 800 mg tablet

    Formulary Changes to the Preferred B3 and B4 Drug Lists

    Drug Name Description of Change Cost-effective Alternatives*
    Asacol HD 800 mg tabletMoving to a higher levelmesalamine 800 mg tablet

    Formulary Changes to the E4 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Acanya gelMoving to a higher levelclindamycin/benzoyl peroxide gel
    Adcirca tabletMoving to a higher leveltadalafil tablet

    Formulary Changes to the E1 and E4 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Aktipak gel pouchNo longer coverederythromycin/benzoyl peroxide gel
    Arimidex tabletNo longer coveredanastrozole tablet
    Atripla tabletNo longer coveredSymfi tablet
    Benicar tabletNo longer coveredolmesartan tablet
    Benicar HCT tabletNo longer coveredolmesartan/hydrochlorothiazide tablet
    Brisdelle capsuleNo longer coveredparoxetine mesylate capsule
    Brovana solutionNo longer coveredPerforomist solution
    butalbital/acetaminophen tabletNo longer coveredbutalbital/acetaminophen/caffeine tablet
    Butrans patchNo longer coveredBuprenorphine transdermal patch
    Celexa tabletNo longer coveredcitalopram tablet
    Climara Pro patchNo longer coveredCombipatch patch
    Clindacin P pledgetsNo longer coveredclindamycin pledgets
    Cosopt eye dropsNo longer covereddorzolamide/timolol eye drops
    Cozaar tabletNo longer coveredlosartan tablet
    Crestor tabletNo longer coveredrosuvastatin tablet
    Diovan tabletNo longer coveredvalsartan tablet
    Diovan HCT tabletNo longer coveredvalsartan/hydrochlorothiazide tablet
    Embeda ER capsuleNo longer coveredmorphine sulfate extended-release tablet
    Fenoprofen capsuleNo longer coverednaproxen tablet
    Fluorouracil 0.5% creamNo longer coveredfluorouracil solution
    FML Forte eye dropsNo longer coveredfluorometholone eye drops
    FML Liquifilm eye dropsNo longer coveredfluorometholone eye drops
    Humalog Jr. KwikpenNo longer coveredNovolog Flexpen
    levalbuterol solutionNo longer coveredalbuterol solution
    Levalbuterol HFA inhalerNo longer coveredProAir HFA inhaler
    Maxalt MLT tabletNo longer coveredrizatriptan orally-disintegrating tablet
    Maxidex eye dropsNo longer covereddexamethasone eye drops
    metformin ER osmotic-release tabletNo longer coveredmetformin extended-release tablet
    Micardis tabletNo longer coveredtelmisartan tablet
    Nalfon capsuleNo longer coverednaproxen tablet
    Neupro patchNo longer coveredropinirole tablet
    Norvasc tabletNo longer coveredamlodipine tablet
    Nuvigil tabletNo longer coveredarmodafinil tablet
    OB Complete Petite capsuleNo longer coveredPrePlus tablet
    Onzetra Xsail nasal powderNo longer coveredsumatriptan nasal spray
    Pradaxa capsuleNo longer coveredXarelto tablet
    Prozac Pulvule capsuleNo longer coveredfluoxetine capsule
    Savaysa tabletNo longer coveredXarelto tablet
    Tobi Podhaler capsuleNo longer coveredtobramycin inhaled
    Tricor tabletNo longer coveredfenofibrate tablet
    Vagifem tabletNo longer coveredestradiol tablet
    Vinate DHA RF gelcapNo longer coveredPrePlus tablet
    Vivelle-dot patchNo longer coveredestradiol patch
    Xalatan eye dropsNo longer coveredlatanoprost eye drops
    Zoloft tabletNo longer coveredsertraline tablet

    Formulary Changes to the M4 (2019) Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    abacavir/lamivudine tabletMoving to a higher levelConsult Doctor
    Albenza tabletMoving to a higher levelConsult Doctor
    alclometasone creamMoving to a higher levelbetamethasone dipropionate cream
    Alphagan P dropsMoving to a higher levelbrimonidine drops
    Amabelz tabletMoving to a higher levelestradiol/norethindrone tablet
    aspirin/dipyridamole capsuleMoving to a higher levelaspirin tablet
    Atrovent HFA inhaler Moving to a higher levelipratropium inhaled
    Azopt suspensionMoving to a higher leveldorzolamide drops
    Betimol dropsMoving to a higher leveltimolol drops
    Blephamide dropsMoving to a higher levelsulfacetamide/prednisolone drops
    bumetanide tabletMoving to a higher levelfurosemide tablet
    butalbital/acetaminophen/caffeine/codeine capsuleMoving to a higher levelbutalbital/acetaminophen/caffeine tablet
    Canasa suppositoryMoving to a higher levelmesalamine suppository
    chlordiazepoxide/clidinium capsuleMoving to a higher levelConsult Doctor
    chlorpromazine tabletMoving to a higher levelConsult Doctor
    Cialis tabletMoving to a higher leveltamsulosin capsule
    Claravis capsuleMoving to a higher levelAmnesteem capsule
    Clobetasol creamMoving to a higher levelhalobetasol propionate cream
    Clobetasol gelMoving to a higher levelhalobetasol propionate cream
    Clobetasol solutionMoving to a higher levelhalobetasol propionate solution
    clonidine patchMoving to a higher levelConsult Doctor
    Colocort enemaMoving to a higher levelhydrocortisone enema
    Combipatch patchMoving to a higher levelestradiol/norethindrone tablet
    Completenate tabletMoving to a higher levelPrePlus tablet
    Compro suppositoryMoving to a higher levelprochlorperazine suppository
    Daliresp tabletMoving to a higher levelConsult Doctor
    dapsone gelMoving to a higher levelclindamycin topical solution
    Denavir creamMoving to a higher levelacyclovir ointment
    Descovy tabletMoving to a higher levelConsult Doctor
    desonide creamMoving to a higher levelhydrocortisone cream
    desonide lotionMoving to a higher levelhydrocortisone lotion
    desonide ointmentMoving to a higher levelhydrocortisone ointment
    desoximetasone creamMoving to a higher levelbetamethasone dipropionate cream
    desoximetasone ointmentMoving to a higher levelbetamethasone dipropionate ointment
    dofetilide capsuleMoving to a higher levelConsult Doctor
    dronabinol capsuleMoving to a higher levelaprepitant capsule or ondansetron tablet
    Elidel creamMoving to a higher leveltacrolimus ointment
    Elmiron capsuleMoving to a higher levelConsult Doctor
    Emtriva capsuleMoving to a higher levelConsult Doctor
    Ery-tab tabletMoving to a higher levelerythromycin tablet
    Erythrocin tabletMoving to a higher levelerythromycin tablet
    ethacrynic acid tabletMoving to a higher levelfurosemide tablet
    Eucrisa ointmentMoving to a higher leveltacrolimus ointment
    Finacea foamMoving to a higher leveltretinoin topical
    Finacea gelMoving to a higher leveltretinoin topical
    Flovent Diskus inhalerMoving to a higher levelAsmanex inhalation
    Flovent HFAMoving to a higher levelAsmanex inhalation
    fluocinonide creamMoving to a higher levelbetamethasone dipropionate cream
    fluocinonide gelMoving to a higher levelbetamethasone dipropionate topical
    fluocinonide ointmentMoving to a higher levelbetamethasone dipropionate ointment
    fluocinonide solutionMoving to a higher levelbetamethasone dipropionate topical
    fluocinonide-e creamMoving to a higher levelbetamethasone dipropionate cream
    fluorouracil creamMoving to a higher levelConsult Doctor
    G Tussin AC liquidMoving to a higher levelguaifenesin/codeine syrup
    hydrocortisone butyrate ointmentMoving to a higher levelhydrocortisone topical
    Hydromet syrupMoving to a higher levelhydrocodone/homatropine tablet
    imipramine capsuleMoving to a higher levelimipramine tablet
    Intelence tabletMoving to a higher levelConsult Doctor
    Invokamet XR tabletMoving to a higher levelInvokamet tablet
    isradipine capsuleMoving to a higher levelamlodipine tablet
    ketoprofen capsuleMoving to a higher levelibuprofen tablet
    Lacrisert insertMoving to a higher levelConsult Doctor
    lansoprazole capsuleMoving to a higher levelpantoprazole tablet
    levocetirizine tabletMoving to a higher levelcetirizine solution
    levorphanol tabletMoving to a higher levelmorphine sulfate tablet
    lidocaine-tetracaine creamMoving to a higher levellidocaine topical
    mesalamine DR tabletMoving to a higher levelmesalamine tablet
    methergine tabletMoving to a higher levelConsult Doctor
    mirtazapine tabletMoving to a higher levelConsult Doctor
    Multaq tabletMoving to a higher levelConsult Doctor
    Myorisan capsuleMoving to a higher levelAmnesteem capsule
    naproxen DS tabletMoving to a higher levelnaproxen tablet
    naproxen sodium tabletMoving to a higher levelnaproxen tablet
    nateglinide tabletMoving to a higher levelConsult Doctor
    nefazodone tabletMoving to a higher levelConsult Doctor
    Nitro-bid ointmentMoving to a higher levelConsult Doctor
    Norpace CR capsuleMoving to a higher leveldisopyramide capsule
    Noxafil DR tabletMoving to a higher levelConsult Doctor
    olopatadine nasal spray Moving to a higher levelazelastine nasal spray
    Onfi suspensionMoving to a higher levelConsult Doctor
    Pradaxa capsuleMoving to a higher levelXarelto tablet
    pramipexole extended-release tabletMoving to a higher levelropinirole tablet
    pramipexole tabletMoving to a higher levelropinirole tablet
    Prempro tabletMoving to a higher levelCovaryx tablet
    Proctofoam-HC foamMoving to a higher levelhydrocortisone cream
    Procto-Med HC creamMoving to a higher levelhydrocortisone cream
    quetiapine extended-release tabletMoving to a higher levelConsult Doctor
    ramipril capsuleMoving to a higher levellisinopril tablet
    rasagiline tabletMoving to a higher levelselegiline tablet
    Relistor tabletMoving to a higher levelConsult Doctor
    repaglinide tabletMoving to a higher levelConsult Doctor
    Restasis dropperetteMoving to a higher levelConsult Doctor
    Restasis multidose dropsMoving to a higher levelConsult Doctor
    scopolamine patch Moving to a higher levelConsult Doctor
    Selzentry tabletMoving to a higher levelConsult Doctor
    Serevent Diskus inhalerMoving to a higher levelConsult Doctor
    sevelamer powder packMoving to a higher levelConsult Doctor
    tetracycline capsuleMoving to a higher levelConsult Doctor
    Tobradex ointmentMoving to a higher leveltobramycin/dexamethasone drops
    Tobradex ST dropsMoving to a higher leveltobramycin/dexamethasone drops
    vancomycin capsuleMoving to a higher levelConsult Doctor
    Vemlidy tabletMoving to a higher levelConsult Doctor
    Viracept tabletMoving to a higher levelConsult Doctor
    Vyvanse chewable tabletMoving to a higher levelConsult Doctor
    Xifaxan tabletMoving to a higher levelConsult Doctor
    Xiidra dropperetteMoving to a higher levelConsult Doctor

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

    Drug Name Description of Change Cost-effective Alternatives*
    adapalene/benzoyl peroxide gel No longer coveredbenzoyl peroxide topical
    Asacol HD tabletNo longer coveredmesalamine tablet
    butalbital/acetaminophen tabletNo longer coveredbutalbital/acetaminophen/caffeine tablet
    Carospir suspensionNo longer coveredspironolactone tablet
    Copaxone syringeNo longer coveredglatiramer acetate syringe
    Delzicol capsule No longer coveredmesalamine tablet
    doxepin creamNo longer coveredtacrolimus ointment
    Emflaza tabletNo longer coveredConsult Doctor
    flunisolide nasal sprayNo longer coveredfluticasone nasal spray
    Folbee Plus tabletNo longer coveredgeneric vitamin b complex + folic acid
    Folbic tabletNo longer coveredgeneric vitamin b complex + folic acid
    HPR Plus foamNo longer coveredhydrocortisone topical
    mometasone nasal sprayNo longer coveredfluticasone nasal spray
    Nexium capsuleNo longer coveredpantoprazole tablet
    Norvir tabletNo longer coveredritonavir tablet
    Ortho D capsuleNo longer coveredcholecalciferol + folic acid
    Pertzye capsuleNo longer coveredZenpep capsule
    Prevacid capsuleNo longer coveredpantoprazole tablet
    Qnasl nasal sprayNo longer coveredfluticasone nasal spray
    Segluromet tabletNo longer coveredSynjardy tablet
    Steglatro tabletNo longer coveredJardiance tablet
    Taclonex topicalNo longer coveredcalcitriene ointment
    Vyzulta dropsNo longer coveredlatanoprost drops
    Zovirax creamNo longer coveredacyclovir ointment

    *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.