Drug List Changes

  • M4 Drug List Changes Effective July 1, 2021

    Drug Name Description of Change Cost-effective Alternatives
    Azopt eye drops No longer covered brinzolamide eye drops
    Hysingla ER tablet No longer covered hydrocodone bitartrate ER tablet
    Lotemax 0.5% ophthalmic gel No longer covered loteprednol 0.5% ophthalmic gel
    Saphris sublingual tablet No longer covered asenapine sublingual tablet
    Truvada tablet No longer covered emtricitabine/tenofovir disoproxil tablet
    Zytiga 500 mg tablet No longer covered abiraterone 500 mg tablet
    Pexeva No longer covered PAROXETINE MESYLATE
    Viibryd No longer covered Citalopram, Escitalopram, Paroxetine or Sertraline