Loading...Loading...November 9, 2021
Every year our pharmacy team updates our covered-drug list, known as our formulary, to reflect the safest, highest-quality, most cost-effective prescription drugs and supplies available. Changes that positively affect employees are made throughout the year. Our annual review is a more comprehensive evaluation to align our formulary with market changes, new products and regulatory requirements.
Our January 1, 2022, formulary updates reflect current scientific findings and new medications on the market. These include:
- New quantity limits and pre-authorization requirements
- Cost-share and tier changes
- Changes to the Optimum Value Medication List and High-Cost-Drug Exclusion List
- Removal of certain medications
Exclusion of certain drugs, medical food and over-the-counter medications
Beginning mid-October, we started mailing letters to employees affected by these updates to outline changes relevant to their prescriptions and explain actions they can take. Our letters always provide options and contact information if employees have questions.
Beginning January 1, 2022, the biologic drug Remicade will move to non-preferred, with Inflectra replacing it as the preferred infliximab product. Biologic, or biosimilar, drugs treat damaging inflammation. Effective January 1, 2022, Remicade will not be covered without a new pre-authorization. Employees can continue treatment uninterrupted and without additional pre-authorization when they transition to Inflectra. Affected employees received a letter explaining this update in mid-September.
Beginning January 1, 2022, our High-Cost-Drug Exclusion (HCDE) List will be renamed Drug Exclusions with Alternatives. It encourages employees to use lower-cost alternatives (including over-the-counter medications) when they’re therapeutically equivalent to higher-cost medications. We review the list annually to address market changes and opportunities for further cost savings for you and your employees.
Please contact your account representative with any questions.