Formulary updates generally take place twice yearly in response to changes in the drug marketplace. The updates happening as of October 1 affect all Commercial segments (including large group, small group and individual segments). This update does not affect Medicare programs.
This formulary update includes the following:
- Brand drugs that have lost patent protection and are now available with generic equivalents
- Select drugs removed from coverage through the Pharmacy & Therapeutics Committee review process
- Drugs that do not meet eligibility requirements (i.e. non-FDA approved or OTC drugs)
- Select generic drugs that require a higher copay
For these changes, 2,033 members across the Commercial market segment received notification letters by September 1.
Click here for a complete list of the October 1 formulary changes.