New quantity limits and other formulary updates as of Sept. 1

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New quantity limits and other formulary updates as of Sept. 1


Commercial plan formulary updates for Sept. 1, 2018, include quantity limits for some drugs and supplies as well as designation of a preferred medication for rosacea treatment.

New quantity limits affect the following drugs and supplies:

  • Attention deficit hyperactivity disorder (ADHD) drugs
  • Diabetic test strips
  • Lyrica
  • Respiratory inhalers 

Please refer to the quantity limits list on for details. The new quantity limits apply to new and existing prescriptions.

We have sent letters to alert members who may be affected by the changes. The letters said that we’ll cover drugs/supplies above the limits if their doctors get our approval first.

Also on Sept. 1, our preferred drug for treatment of rosacea will be:

  • Metronidazole 0.75% Topical Cream
  • Metronidazole 0.75% Topical Gel
  • Metronidazole 1% Topical Gel 

Your patients will not need preauthorization to use the above drugs. But all other creams and gels used for treating rosacea will need our preauthorization before your patients can get a new or refill a prescription.

Remember, your offices can fax pharmacy preauthorization requests to us at 1-800-249-1367.