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

December 2017. The following changes to the drug list are effective December 22, 2017:

Formulary Additions

  • Moxifloxacin 0.5% ophthalmic solution add Tier 1
  • Mesalamine 1.2 gm delayed release tablet add Tier 1 with quantity limit
  • Testosterone transdermal solution add Tier 1 with preauthorization
  • Doxycycline Hyclate delayed release tablet add Tier 1 with preauthorization
  • Doryx add Tier 3 with preauthorization
  • Cotempla XR-ODT add Tier 3 with medical necessity preauthorization
  • Duzallo add Tier 3 with medical necessity preauthorization
  • Bevyxxa add Tier 3 with medical necessity preauthorization
  • Gocovri add Tier 3 with medical necessity preauthorization
  • Endari add Tier 3 with quantity limit and step therapy

Tier update

  • Vigamox 0.5% ophthalmic solution change Tier 2 to Tier 3
  • Lialda change Tier 2 to Tier 3

Preauthorization update

  • Azasan, Amrix, Veregen 15% ointment, Flector patch, Zyclara, Zyclara Pump, Doxycycline Hyclate delayed release tablet add medical necessity preauthorization

Step Therapy update

  • Relpax (Eletriptan) add step therapy

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

November 2017. The following changes to the drug list are effective November 22, 2017:

Formulary Additions

  • Atomoxetine capsule add Tier 1 with quantity limit, and stimulants preauthorization
  • Olopatadine 0.2% solution add Tier 1
  • Sevelamer Carbonate packet add Tier 1
  • Buprenophine Patch add Tier 1 with step therapy and quantity limit
  • Doxepin 5% cream (Zonalon, Prudoxin) add Tier 1 with medical necessity preauthorization
  • Siliq add Tier 3, SP with quantity and medical necessity preauthorization
  • Nolix add Tier 1 with medical necessity preauthorization
  • Nerlynx add Tier 3, SP with quantity limit and preauthorization
  • Idhifa add Tier 3, SP with quantity limit and preauthorization
  • ArmonAir RespiClick, FloLipid add Tier 3 with medical necessity preauthorization

Removed from Formulary

  • Granirelix, Endometrin, miscellaneous dermatological products

Tier update

  • Renvela packet change Tier 2 to Tier 4; consider sevelamer carbonate packet

Preauthorization update

  • Abilify Maintena, capecitabine (Xeloda), and Jakafi add preauthorization
  • Levorphanol tablet add medical necessity preauthorization

Quantity Limit update

  • Diastat gel update quantity limit

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

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

December: All States

December 2017. The following changes to the drug list are effective December 22, 2017:  

Formulary Addition

  • Atomoxetine add Tier 1 with quantity limit and stimulant preauthorization
  • Eletriptan add Tier 1 with quantity limit and step therapy
  • Moxifloxacin 0.55 solution add Tier 1
  • Olopatadine 0.2% solution add Tier 1
  • Mesalamine delayed release tablet add Tier 1 with quantity limit
  • Buprenorphine patch add Tier 1 with quantity limit and step therapy
  • Testosterone transdermal solution add Tier 1 with preauthorization
  • Nerlynx add Tier 4, SP with quantity limit and preauthorization
  • Idhifa add Tier 4, SP with quantity limit and preauthorization
  • Tyzeka add Tier 3 with medical necessity preauthorization
  • Otovel otic solution add Tier 3 with medical necessity preauthorization 
  • Endari add Tier 3 with quantity limit and step therapy

Step Therapy update

  • Dutasteride remove step therapy

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

November: Idaho and Montana Changes

For Oregon changes, see the next section below.

November 2017. The following changes to the drug list are effective November 22, 2017:

Removed from Formulary

  • Android capsule; consider methyltestosterone
  • Aubagio, Avonex; consider Glatopa, Tecfidera, Copaxone 40mg
  • Copaxone 20 mg; consider Glatopa 20 mg
  • EpiPen Jr 2-Pak; Epinephrine solution 0.15mg/0.3ml
  • Cordan tape; consider betamethasone dipropionate, betamethasone valerate,  halobetasol
  • Phenoxybenzamine powder; Phenoxybenamine capsule
  • Enjuvia; product discontinued
  • Tekturna HCT, Ilaris, Kineret

Preauthorization update

  • Desonide, Picato gel add medical necessity preauthorization
  • Phenoxybenzamine capsule add preauthorization
  • Desonate gel remove preauthorization

Tier update

  • Ribavirin, Intron A, Tobramycin nebulization solution, Rebetol solution, Ribasphere capsule, Sildenafil tablet, Ribasphere tablet, Emsam patch, Pegasys, Banzel, Adcirca, Ampyra, Gilenya, Neudexta, Pegasys ProClick, Tecfidera, Copaxone 40 mg, PegIntron, Glatopa 20 mg with Tier update

Quantity Limit update

  • Divalproex Sodium ER with quantity limit update
  • Extavia, Glatopa 20 mg add quantity limit

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

November: Oregon Changes

November 2017. The following changes to the drug list are effective November 22, 2017:

Removed from Formulary

  • Android capsule; consider methyltestosterone
  • Aubagio, Avonex; consider Glatopa, Tecfidera, Copaxone 40mg
  • Copaxone 20 mg; consider Glatopa 20 mg
  • EpiPen Jr 2-Pak; consider Epinephrine solution 0.15mg/0.3ml
  • Cordan tape; consider betamethasone dipropionate, betamethasone valerate,  halobetasol
  • Phenoxybenzamine powder; consider Phenoxybenamine capsule
  • Enjuvia; product discontinued
  • Tekturna HCT, Ilaris, Kineret

Preauthorization update

  • Desonide, Picato gel add medical necessity preauthorization
  • Phenoxybenzamine capsule add preauthorization
  • Desonate gel remove preauthorization

Tier update

  • Phenoxybenzamine capsule, Ribavirin, Divalproex Sodium ER, Ribasphere, Tobramycin nebulization solution, Sildenafil tablet, Emsam patch, Banzel, Gilenya, Neudexta, Tecfidera, Copaxone 40 mg, Glatopa 20 mg with Tier update

Quantity Limit update

  • Divalproex Sodium ER with quantity limit update
  • Extavia, Glatopa 20 mg add quantity limit

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 11/20/2017