Effective Oct. 1, 2023, the following generic inhaler products will not be covered in the formularies for Harvard Pilgrim Health Care commercial, Tufts Health Plan commercial and Tufts Health Direct. Alternative NDCs for the same drug, and similar agents, are covered on our formularies.
Product ID (NDC) | Product Label Name | Alternative Covered Agent(s) |
66993013597 | fluticasone furoate-vilanterol inhalation 100-25 | Breo Ellipta Inhalation |
66993013697 | fluticasone furoate-vilanterol inhalation 200-25 | Breo Ellipta Inhalation |
66993007896 | fluticasone propionate HFA 44mcg |
|
66993007996 | fluticasone propionate HFA 110mcg |
|
66993008096 | fluticasone propionate HFA 220mcg |
|
66993001968 | albuterol sulfate HFA | albuterol HFA (generic for Proventil and ProAir) |
*Flovent HFA and Flovent Diskus will be discontinued on December 1, 2023, and no longer covered as of January 1, 2024.
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