| Drug Name |
Description of Change |
Cost-effective Alternatives |
Emflaza oral suspension
|
No longer covered |
prednisone, deflazacort
|
Folic acid 5mg capsules
|
No longer covered |
folic acid tablets
|
Folic acid vials
|
No longer covered |
Covered under medical benefit
|
Glucagon 1mg vials
|
No longer covered |
glucagon 1mg emergency kit
|
Nityr tablets
|
No longer covered |
nitisinone capsules
|
Oxistat 1% lotion
| No longer covered
| ciclopirox, clotrimazole, econazole, ketoconazole, nystatin
|
R-tanna tablets
| No longer covered
| promethazine/phenylephrine
|
Sulconazole 1% solution
| No longer covered
| ciclopirox, clotrimazole, econazole, ketoconazole, nystatin
|
Zenzedi 2.5mg & 7.5mg tablets
| No longer covered
| dextroamphetamine tablets
|