Prescription Drug Information and News

Our PacificSource Drug Lists are updated monthly.
Learn more about our PacificSource Drug Lists >  

Our drug lists are available in a searchable online format.  Find a Drug >   

Preferred Drug List (PDL) Changes

February 2019. The following changes to the drug list are effective February 22, 2019:

Formulary Additions

  • First-Omeprazole suspension add Tier 3 with quantity limit and preauthorization (preauthorization for ages greater than 6 years)
  • First-Lansoprazole suspension add Tier 3 with preauthorization (preauthorization for ages greater than 6 years)
  • Idelvion solution add Tier 3 with SP, preauthorization
  • Xolair solution add Tier 3 with preauthorization
  • Tegsedi solution add Tier 3 with limited access, quantity limit and preauthorization
  • Inveltys suspension add Tier 3
  • Xofluza tablet add Tier 3 with quantity over time limit
  • Xyosted add Tier 3 with medical necessity preauthorization
  • Arakoda tablet add Tier 3
  • Lorbrena tablet add Tier 3 with limited access, quantity limit and preauthorization
  • Sympazan film add Tier 3 with quantity limit and medical necessity preauthorization
  • Xelpros emulsion add Tier 3
  • Revcovi solution add Tier 3 with limited access and preauthorization
  • Bryhali lotion add Tier 3 with medical necessity preauthorization
  • Abilify MyCite tablet add Tier 3 with medical necessity preauthorization

Quantity Limit Update

  • Quinine sulfate capsule, Qualaquin capsule, Flonase, Flunisolide nasal solution, Fluticasone nasal suspension - add quantity limit
  • Concerta 27mg tablet, Concerta 18mg tablet, methylphenidate ER 27mg tablet, methylphenidate ER 18mg tablet - update quantity limit

Tier Update

  • Xolair solution

Preauthorization Updates

  • Rayos tablet add medical necessity preauthorization
  • Dupixent remove medical necessity (preauthorization remains)

See the PacificSource Drug Lists page for the current drug list.

January 2019. The following changes to the drug list are effective January 22, 2019:

Formulary Additions

  • Dalfampridine ER 10mg tablet add Tier 1 with SP, quantity limit and preauthorization
  • FreeStyle Libre System add Tier 2 with preauthorization
  • DexCom G6 system add Tier 2 with preauthorization
  • Xepi cream add Tier 3 with quantity limit
  • Galafold capsule add Tier 3 with limited access, quantity limit and preauthorization
  • Epidiolex solution add Tier 3 with SP and preauthorization
  • Incassia tablet add Tier 0 with ACA restrictions may apply
  • Humira Pen (CD/UC/HS starter kit) add Tier 3 with SP, quantity limit and preauthorization
  • Takhzyro solution add Tier 3 with SP and preauthorization
  • Jivi solution add Tier 3 with SP and preauthorization
  • Nivestym solution add Tier 3 with SP and preauthorization
  • Tiglutik suspension add Tier 3 with medical necessity preauthorization
  • Ztlido patch add Tier 3 with quantity limit and medical necessity preauthorization
  • Xerava solution add Tier 3
  • Copiktra capsule add Tier 3 with limited access and medical necessity preauthorization
  • Altreno lotion add Tier 3
  • Libtayo solution add Tier 3 with limited access and preauthorization
  • Vizimpro tablet add Tier 3 with SP, limited access, quantity limit and preauthorization
  • Arikayce suspension add Tier 3 with limited access, quantity limit and preauthorization
  • Nocdurna tablet add Tier 3 with quantity limit and preauthorization
  • Talzenna capsule add Tier 3 with SP, quantity limit and preauthorization

Quantity Limit Update

  • Methylphenidate ER 36mg tablet, Concerta 36mg tablet update quantity limit

Tier Update

  • Neupogen solution, Zarxio solution, Genvoya tablet, Biktarvy tablet

Removed/Excluded from Formulary

  • Yodoxin tablet, Gelclair gel, OraMagicRx, SaliCept, Caphosol, Numoisyn, Mucotrol, Aquoral, MuGard, Episil, GelX, Orafate, ProThelial

See the  PacificSource Drug Lists page for the current drug list.

State-based Drug List (ID, MT, OR) Changes

Ferbruary: All States

February 2019. The following changes to the drug list are effective February 22, 2019:

Formulary Addition

  • First-Omeprazole suspension add Tier 3 with quantity limit and preauthorization (preauthorization for ages greater than 6 years)
  • First-Lansoprazole suspension add Tier 3 with preauthorization (preauthorization for ages greater than 6 years)
  • Idelvion solution add Tier 4 with SP, preauthorization
  • Tegsedi solution add Tier 4 with limited access, quantity limit and preauthorization
  • Inveltys suspension add Tier 3
  • Lorbrena tablet add Tier 4 with limited access, quantity limit and preauthorization
  • Dupixent solution add Tier 4 with quantity limit and preauthorization

Quantity Limit Update

  • Quinine sulfate capsule add quantity over time limit

See the  PacificSource Drug Lists page for the current drug list.

January: All States

January 2019. The following changes to the drug list are effective January 22, 2019:

Formulary Addition

  • Lidocaine Ointment 5% add Tier 1 with quantity over time limit
  • Dalfampridine ER 10mg tablet add Tier 4 with SP, quantity limit and preauthorization
  • Kengreal solution add Tier 4 (Medical Benefit only)
  • Rubraca tablet add Tier 4 with SP, partial fill, quantity limit and preauthorization
  • Zejula capsule add Tier 4 with SP, limited access, quantity limit and preauthorization
  • Lynparza tablet add Tier 4 with SP, limited access, partial fill, quantity limit and preauthorization
  • FreeStyle Libre system add Tier 2 with preauthorization
  • DexCom G6 add Tier 2 with preauthorization
  • Methylphenidate ER 72mg tablet add Tier 1 with quantity limit and preauthorization
  • Biktarvy tablet add Tier 2
  • Galafold Capsule add Tier 4 with limited access, quantity limit and preauthorization
  • Epidiolex solution add Tier 4 with SP and preauthorization
  • Incassia tablet add Tier 0 with ACA restrictions may apply
  • Takhzyro solution add Tier 4 with preauthorization
  • Jivi solution add Tier 4 with preauthorization
  • Nivestym solution add Tier 4 with preauthorization
  • Copiktra capsule add Tier 4 with preauthorization
  • Vizimpro tablet add Tier 4 with limited access, SP, quantity limit and preauthorization
  • Arikayce suspension add Tier 4 with limited access, quantity limit and preauthorization
  • Talzenna capsule add Tier 4 with SP, quantity limit and preauthorization

Quantity Limit Update

  • OneTouch Ultra Blue test strips, OneTouch Verio test strips add quantity limit

Removed from Formulary

  • Ampyra tablet; consider Dalfampridine ER tablet

See the  PacificSource Drug Lists page for the current drug list. 

Non-FDA Approved Compounding Agents

A compounded medication is when a pharmacist combines multiple ingredients together. Compounded claims often use what we called "bulk powders." These powders act as a mixing agent/congealing agent to hold the finished product together. These ingredients may not always be approved by the Food and Drug Administration (FDA), thus may not have been reviewed for safety and efficacy. To ensure you are taking medications proven to be safe and effective, beginning August 1, 2017, the non-FDA approved ingredients will be removed from coverage on your plan.

Examples of common non-FDA approved agents:

  • Cellulose (bulk) powder
  • Alcohol, usp 95%
  • Cream base
  • Fatty acid base
  • Gelatin capsules (empty)
  • Hypromellose (bulk) powder
  • Hormone cream base
  • Propylene glycol liquid
  • Thyroid powder
  • Silica gel
  • Stevia (bulk) powder
  • Vitamin E acetate (bulk) liquid

See the non-FDA approved bulk powder agents for the full list >

“Partial Fill” Lets a Patient Test a New Prescription

As you know, some drugs not only have a high cost, but have side effects that make them hard to tolerate for long-term use. Beginning February 22, 2016, these medications will be dispensed in a limited amount, on the first fill only, for half the normal copay. This “partial fill” will act as a trial period to see if the patient is able to successfully take the drug. 

A week into the first fill, a Caremark Specialty Care Team pharmacist or nurse will contact the patient. They will check on side effects and see if the patient was able to tolerate the drug. The Care Team will also answer questions and concerns about the treatment. If the trial period is a success, the patient will continue the drug. After this initial trial, all future fills will be for the full amount. 

On our drug lists, partial-fill drugs are identified by “Partial Fill” in the Restrictions column.

Partial-fill drugs include:

  • Afinitor
  • Bosulif
  • Erivedge
  • Gleevec
  • Inlyta
 
  • Jakafi
  • Nexavar
  • Odomzo
  • Sprycel
  • Sutent
 
  • Tafinlar
  • Tarceva
  • Targretin
  • Tasigna
  • Votrient
 
  • Xalkori
  • Xtandi
  • Zolinza
  • Zykadia
  • Zytiga
 

Preauthorization and Step Therapy Drug Lists with Criteria

Our Preauthorization Policies and Step Therapy Policies documents contain lists of drugs that require preauthorization or that are Step Therapy drugs, as well as their criteria. These two documents replace the one-page "PDL/VDL Preauthorization and Step Therapy Drug Lists" document. You may also use Preauthorization Policies to access our coverage rules for compound medications.

Flu and Pertussis Vaccination Coverage

Our flu vaccination page now includes information about your coverage for whooping cough (pertussis), as well as seasonal flu vaccination and general information.

Consumer Updates from the FDA

Quick Links

PacificSource Drug Lists—our comprehensive drug list page

Preventive Drug List

Incentive Drug List

Prescription drug claim form

Prescription Drug Preauthorization Request (Fax)

InTouch for Members

Are you a Medicare or Medicaid member?

If so, we have a website just for you!

Cool Tools for Managing Your Rx

On the CVS Caremark® website, you'll find tools to help you track pharmacy expenses, save on drug costs, manage your prescriptions, and more. Register by using the member ID number and group code on your ID card. To start, visit Caremark.com.

Why Choose Generics?

Generic prescription medicines are safe, effective, and a good value. Save money by using them instead of brand name drugs whenever possible.

Questions?

Contact our Pharmacy Services Department:

  • Phone: (541) 225-3784
  • Toll-free: (844) 877-4803
  • Email: Use our online Contact Us form
Last updated 1/15/2019