Drug List Changes

  • M4 Drug List Changes Effective April 1, 2020

    Drug Name Description of Change Cost-effective Alternatives
    Apriso extended-release capsule No longer covered mesalamine extended-release capsule
    Aubagio tablet No longer covered Consult doctor
    Bethkis inhalation solution No longer covered tobramycin inhalation solution
    Ingrezza capsule No longer covered Austedo tablet or tetrabenazine tablet
    Naftin 1% gel No longer covered naftifine 1% gel
    Restasis Multidose eye drops No longer covered Restasis eye drops
    Sandostatin LAR Depot injection No longer covered Somatuline Depot injection
    Signifor LAR injection No longer covered Somatuline Depot injection
    Tobi Podhaler inhalation powder No longer covered tobramycin inhalation solution