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

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

Formulary Additions

  • Dovato tablet add Tier 2 with quantity limit
  • Evenity prefilled syringe add Tier 3 with SP and preauthorization
  • Balversa tablet add Tier 3 with limited access and preauthorization
  • Spravato nasal solution add Tier 3 with SP, quantity limit and preauthorization
  • Diclovix kit add Tier 3 with medical necessity preauthorization
  • Ergotamine-Caffeine 1-100mg tablet add Tier 1 with quantity over time limit
  • Clobetasol emollient cream add Tier 1
  • Lanthanum carbonate chewable 500mg tablet add Tier 1 with quantity limit
  • Solifenacin tablet add Tier 1 with step therapy
  • Ranolazine extended release tablet add Tier 1 with quantity limit and step therapy
  • Cyclobenzaprine extended release tablet add Tier 1 with medical necessity preauthorization
  • Aliskiren tablet add Tier 1 with quantity limit
  • Xiaflex solution add Tier 3 with preauthorization
  • Diacomit capsule add Tier 3 with limited access, quantity limit and preauthorization
  • Tivorbex capsule add Tier 3 with medical necessity preauthorization
  • Fosrenol packet add Tier 3 with quantity limit
  • Subvenite tablet add Tier 3
  • Tarina FE 1/20 tablet add Tier 0 (ACA drug)
  • Dexchlorpheniramine solution add Tier 1
  • Levorphanol tablet add Tier 1 with quantity limit and medical necessity preauthorization
  • Nivestym solution add Tier 3 with preauthorization
  • Pyridostiogmine bromide solution add Tier 1
  • Tarina 24 FE add Tier 0 (ACA drug)
  • Aimovig add Tier 3 with quantity limit and medical necessity preauthorization
  • TaperDex 7-day pack add Tier 1
  • Ryclora solution add Tier 3
  • Mayzent tablet add Tier 3 with SP and preauthorization
  • Mavenclad tablet add Tier 3 with SP, quantity over time limit and preauthorization

Step Therapy Updates

  • Belsomra tablet – update step therapy
  • Rozerem tablet, Intermezzo tablet – add step therapy
  • Ambien tablet, Ambien CR tablet, Lunesta tablet – remove step therapy

Quantity limit Updates

  • Tobramycin nebulizer solution, Tobi nebulizer solution, Dexcom G6 transmitter – add quantity over time limit
  • Silenor tablet – add quantity limit

Tier Update

  • Ranexa tablet, Mestinon syrup – update tier

Preauthorization Update

  • Fenoprofen 600mg tablet, Mefenamic acid capsule – add medical necessity preauthorization (remove step therapy)

Removed from Formulary

  • Acyclovir intravenous solution, Famvir tablet, Oscion cleanser, Victrelis capsule, Vitekta tablet

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

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

Formulary Additions

  • Acyclovir cream add Tier 1 with step therapy
  • Praziquantel tablet add Tier 1
  • Prograf solution add Tier 3
  • Vigabatrin tablet add Tier 1 with SP and preauthorization
  • Toremifene citrate tablet add Tier 1
  • Sirolimus solution add Tier 1
  • Sirolimus tablet add Tier 1
  • Sevelamer tablet add Tier 1 with quantity limit
  • Buprenorphine-Naloxone oral film add Tier 1 with quantity limit
  • Afrezza powder add Tier 3 with medical necessity preauthorization
  • Clonidine weekly patch add Tier 1 with quantity limit
  • Vigadrone packet add Tier 1 with SP and preauthorization
  • Halobetsol foam add Tier 1 with medical necessity preauthorization
  • Lexette foam add Tier 3 with medical necessity preauthorization
  • Dvorah tablet tablet add Tier 3 with quantity limit
  • Tresiba solution add Tier 2
  • Tirosine oral solution add Tier 3
  • Bijuva capsule add Tier 3
  • Inbrija capsule add Tier 3 with medical necessity preauthorization
  • Apadaz tablet add Tier 3 with medical necessity preauthorization
  • Tremfya auto-injector pen add Tier 3 with SP, quantity limit and medical necessity preauthorization
  • Cablivi kit add Tier 3 with limited access and preauthorization
  • Lotemax SM gel add Tier 3
  • Infugem solution add Tier 3 with SP and medical necessity preauthorization
  • Prograf packet add Tier 3
  • Kisqali pack add Tier 3 with SP, quantity limit and medical necessity preauthorization

Step Therapy Update

  • Uloric tablet - add step therapy

Quantity Limit Updates

  • Tiagabine 2mg tablet – update quantity limit
  • Kisqali tablet – add quantity limit

Tier Update

  • Renagel tablet, Fareston tablet – update tier

Preauthorization Updates

  • Syprine capsule, trientine capsule – add preauthorization
  • Sofosbuvir-velpatasvir – remove medical necessity

Removed from Formulary

  • Sil-K pad, KelaRx Gel, Chloral hydrate crystals

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

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

July: All States

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

Formulary Additions

  • Clobetasol emollient cream add Tier 1
  • Lanthanum chewable tablet add Tier 1 with quantity limit
  • Solifenacin tablet add Tier 1 with step therapy
  • Ranolazine extended release tablet add Tier 1 with quantity limit and step therapy
  • Aliskiren tablet add Tier 1 with quantity limit
  • Xiaflex solution add Tier 4 with SP and preauthorization
  • Diacomit capsule add Tier 4 with limited access, quantity limit and preauthorization
  • Tarina FE add Tier 0 (ACA drug)
  • Tarina 24 FE add Tier 0 (ACA drug)
  • Nivestym solution add Tier 4 with SP and preauthorization
  • Spravato solution add Tier 4 with SP, quantity limit and preauthorization
  • Pyridostigmine bromide solution add Tier 1
  • Mayzent tablet add Tier 4 with SP and preauthorization
  • Mavenclad tablet add Tier 4 with SP, quantity over time limit and preauthorization
  • Dovato tablet add Tier 2 with quantity limit
  • Evenity prefilled syringe add Tier 4 with SP and preauthorization
  • Balversa tablet add Tier 4 with limited access and preauthorization

Quantity Limit Update

  • Tobramycin nebulizer solution, Dexcom G6 transmitter – add quantity over time limit

Removed from Formulary

  • Mestinon syrup; consider pyridostigmine bromide syrup
  • Fosrenol chewable tablet; consider lanthanum carbonate chewable tablet
  • Vesicare tablet; consider oxybutynin, tolterodine, trospium, solifenacin tablet
  • Ranexa tablet; consider ranolazine extended release tablet
  • Tekturna tablet; consider aliskiren tablet
  • Vitekta tablet

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

June: All States

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

Formulary Additions

  • Ergotamine-caffeine tablet add Tier 1 with quantity over time limit
  • Praziquantel tablet add Tier 1
  • Vigabatrin tablet add Tier 4, with SP and preauthorization
  • Toremifene citrate tablet add Tier 1
  • Sirolimus solution add Tier 1
  • Sevelamer tablet add Tier 1 with quantity limit
  • Buprenorphine-Naloxone oral film add Tier 1 with quantity limit
  • Vituz solution add Tier 3
  • Zohydro ER add Tier 3 with quantity limit and step therapy
  • Sofosbuvir-Velpatasvir tablet add Tier 4 with SP, quantity limit and preauthorization
  • Clonidine weekly patch add Tier 1 with quantity limit
  • Vigadrone packet add Tier 4 with SP and preauthorization
  • Tresiba solution add Tier 2
  • Jasmiel tablet add Tier 0 (ACA drug)
  • Efavirenz tablet add Tier 1
  • Cablivi kit add Tier 4 with limited access and preauthorization

Preauthorization Update

  • Trientine capsule – add preauthorization

Removed from Formulary

  • Biltricide tablet; consider praziquantel tablet
  • Fareston tablet; consider toremifene citrate tablet
  • Rapamune solution; consider sirolimus solution
  • Renagel tablet; consider sevelamer tablet
  • Sustiva tablet; consider efavirenz tablet
  • Sabril tablet; consider vigabatrin tablet
  • Suboxone film; consider buprenorphine-naloxone film or sublingual tablets
  • Phenazopyridine 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 6/20/2019