Drug List Changes

  • Preferred B3 drug list changes effective January 1, 2023

    Drug Name Description of Change Cost-effective Alternatives
    Clocortolone Cream
    Moving to Tier 3 Fluocinolone Cream
    Condylox Gel
    Moving to Tier 3 Podofilox Topical Solution
    Esbriet tablet 267 mg & 801 mg Moving To Tier 3 Pirfenidone tablet 267 mg and 801 mg
    Incruse Ellipta Moving To Tier 3 Spiriva Respimat Inhaler
    Lipofen Capsule Moving To Tier 3 Fenofibrate Tablet Generic
    Nexavar tablet Moving To Tier 3 Sorafenib tablet
    Norpace CR Capsule Moving To Tier 3 Disopyramide capsule
    Targretin gel Moving To Tier 3 Bexarotene gel
    Tramadol ER tablet brand Moving To Tier 3 Tramadol tablet generic
    Vimpat oral solution Moving To Tier 3 Lacosamide oral solution
  • M4 drug list changes effective January 1, 2023

    Drug Name Description of Change Cost-effective Alternatives
    Acyclovir cream Moving to Tier 3 Acyclovir tablet
    Asmanex inhaler & Asmanex HFA inhaler Moving to Tier 3 Flovent HFA inhaler
    Beser Lotion No longer covered Fluticasone Cream
    Betamethasone Valerate No longer covered Betamethasone Valerate Cream
    BPO Towelette No longer covered Benzoyl Peroxide Gel
    Clobetasol Emulsion Foam No longer covered Clobetasol Cream
    Clobetasol Propionate Foam No longer covered Clobetasol Cream
    Clocortolone Cream Moving To Tier 3 Fluocinolone Cream
    Dapsone Gel and Dapsone Gel with Pump No longer covered Tretinoin Gel
    Deferiprone tablet Moving to Tier 4 Consult doctor
    Diflorasone cream and ointment No longer covered Betamethasone Valerate Cream
    Dovato tablet Moving To Tier 3 Consult doctor
    Doxycycline Hyclate Tablet No longer covered Doxycycline Monohydrate Tablet
    Dutasteride-Tamsulosin capsule Moving To Tier 3 Tamsulosin capsule
    Edular sublingual tablet No longer covered Zolpidem Tablet
    Esbriet tablet 267 mg & 801 mg No longer covered Pirfenidone tablet 267 mg and 801 mg
    Ferriprox tablet No longer covered Deferiprone tablet
    Flurandrenolide lotion No longer covered Flurandrenolide cream
    Fluticasone Propionate Lotion No longer covered Fluticasone Cream
    Genvoya tablet Moving To Tier 3 Consult doctor
    Halcinonide Cream No longer covered Betamethasone Valerate Cream
    Hydrocortisone Lotion No longer covered Hydrocortisone Cream
    Incruse Ellipta No longer covered Spiriva Respimat Inhaler
    Ketoconazole Foam No longer covered Ketoconazole Cream
    Ketodan Foam No longer covered Ketoconazole Cream
    Menostar patch No longer covered Estradiol patch
    Mesalamine enteric coated tablet Moving To Tier 3 Mesalamine enteric coated capsule
    Nexavar tablet No longer covered Sorafenib tablet
    Odefsey tablet Moving To Tier 3 Consult doctor
    Ofloxacin tablet Moving To Tier Ciprofloxacin tablet
    Oxycodone-Acetaminophen 2.5-300 Mg Moving To Tier 3 Oxycodone W/Acetaminophen 2.5-325 Mg
    Paliperidone ER tablet Moving To Tier 3 Olanzapine tablet
    Prezcobix tablet Moving To Tier 3 Consult doctor
    Relexxii tablet No longer covered Methylphenidate ER capsule or tablet
    Samsca Tablet No longer covere> Tolvaptan tablet
    Scalacort lotion No longer covered Hydrocortisone Cream
    Selenium Sulfide 2.3% Shampoo No longer covered Selenium Sulfide 2.25% Shampo>
    Targretin gel No longer covered Bexarotene gel
    Toviaz tablet No longer covered Fesoterodine tablet
    Triamcinolone acetonide ointment No longer covered Triamcinolone acetonide cream
    Triumeq tablet Moving To Tier 3 Consult doctor
    Vimpat oral solution No longer covered Lacosamide oral solution
    Zyflo Tablet No longer covered Zileuton Er Tablet