Changes to existing prior authorization programs
| Updates to existing prior authorization programs | |||
| Drug | Plan | Eff. date | Policy & additional information |
| Advair HFA, Anoro Ellipta, Breo Ellipta, Budesonide/formoterol, Dulera, Proair Respiclick, Proair Digihaler | Tufts Health RITogether | Feb. 1, 2024 | Respiratory Inhalers |
| Cyclosporine 0.05% ophthalmic emulsion, Cequa | Tufts Health RITogether | Feb. 1, 2024 | Medications for Dry Eye Disease |
| Repatha | Tufts Health RITogether | Feb. 1, 2024 | PCSK9 Inhibitor Therapy |
| Non-Formulary Exceptions | Harvard Pilgrim Health Care commercial, Tufts Health Plan commercial, Tufts Health Direct | Feb. 1, 2024 | Non-Formulary Exceptions (Harvard Pilgrim, Tufts Health Plan) |
| Drug status changes | |||
| Drug | Plan | Eff. Date | Policy and Additional Information |
| Forfivo XL | Tufts Health Together | Jan. 2, 2024 | MassHealth is removing Forfivo XL from the Brand-Over-Generic List (BOGL). The generic will continue to require prior authorization.
Criteria can be found at the MassHealth Drug List (MHDL). Please keep in mind that updated coverage and criteria will be available on the MHDL on or after the effective date. |
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