| 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 |