Drug List Changes

  • Effective October 01, 2018

    Formulary Changes to the Preferred B2 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Mephyton 5mg tabletNo longer coveredphytonadione 5mg tablet

    Formulary Changes to the Preferred B3 and B4 Drug Lists

    Drug Name Description of Change Cost-effective Alternatives*
    Mephyton 5mg tabletMoving to a higher levelphytonadione 5mg tablet

    Formulary Changes to the E4 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Mephyton 5mg tabletMoving to a higher levelphytonadione 5mg tablet

    Formulary Changes to the M1, M2 and M4 Drug Lists

    Drug Name Description of Change Cost-effective Alternatives*
    Biltricide tabletNo longer coveredpraziquantel tablet
    DermacinRx Lexitral PharmaPak solutionNo longer covereddiclofenac 1.5% solution
    Lido-K 3% lotionNo longer coveredlidocaine 3% cream
    Lidopril 2.5%-2.5% creamNo longer coveredlidocaine 2.5%/prilocaine 2.5% cream
    LidoRx 3% gelNo longer coveredlidocaine 3% cream
    Lidozion 3% lotionNo longer coveredlidocaine 3% cream
    Welchol tabletNo longer coveredcolesevelam tablet
    Zavesca capsuleNo longer coveredmiglustat capsule

    Formulary Changes to the Value-Based V1 Drug List

    Drug Name Description of Change Cost-effective Alternatives*
    Biltricide tabletMoving to a higher levelpraziquantel tablet
    Mephyton 5mg tabletMoving to a higher levelphytonadione 5mg tablet
    Welchol tabletMoving to a higher levelcolesevelam 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.