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

May 2018. The following changes to the drug list are effective May 22, 2018:

Formulary Additions

  • Alunbrig add Tier 3 with preauthorization
  • Atazanavir capsule add Tier 1
  • Biktarvy add Tier 3
  • Bydureon BCise add Tier 3 with medical necessity preauthorization
  • Carvedilol extended release capsule add Tier 1 with quantity limit
  • Clenpiq add Tier 3
  • Depo-Provera 150mg/ml prefilled syringe add Tier 3
  • Erleada tablet add Tier 3 with preauthorization
  • Estradiol Vaginal Cream 0.1mg/gm add Tier 1
  • Glatiramer 20mg/ml prefilled syringe add Tier 3, with SP, preauthorization, quantity limit
  • Glatopa 40mg/ml prefilled syringe add Tier 3 with SP, medical necessity preauthorization
  • Harvoni tablet add Tier 3 with SP, medical necessity preauthorization
  • Impoyz cream add Tier 3 with medical necessity preauthorization
  • Linzess 72 mcg capsule add Tier 3 with quantity limit, step therapy
  • Lonhala add Tier 3 with medical necessity preauthorization
  • Lyrica CR tablets add Tier 3 with medical necessity preauthorization
  • Medroxyprogesterone 150mg/ml prefilled syringe add Tier 1
  • Roweepra XR add Tier 1
  • Selzentry oral solution add Tier 2
  • Sinuva add Tier 3 with preauthorization
  • Sublocade injection add Tier 3 with preauthorization
  • Symdeko add Tier 3 with Limited Access, quantity limit, preauthorization
  • Xhance nasal spray add Tier 3 with medical necessity preauthorization
  • Xigduo XR tablet add Tier 2
  • Zenpep capsule add Tier 3

Preauthorization Update

  • Fenoprofen capsule, Nalfon add medical necessity preauthorization

Quantity Limit Update

  • Fluvoxamine 25mg, Fluvoxamine 50mg, Meloxicam 7.5mg remove quantity limit
  • Linzess 145mcg, Linzess 290mcg, Glatopa 20mg/ml add quantity limit

Tier Update

  • Estrace Cream, Reyataz, TriLyte, GaviLyte-N, GaviLyte-G, GaviLyte-C, Copaxone 40mg/ml, Copaxone 20mg/ml with tier update

Removed from Formulary

  • Mineral Oil Heavy, Muri-Lube, Uroqid #2, Cascara Sagrada
  • Verelan removed from Incentive/Preventive lists 

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

Preferred Drug List (PDL) Changes

April 2018. The following changes to the drug list are effective April 22, 2018:

Formulary Additions

  • Tenofovir tablet add Tier 1
  • Stelara add Tier 3, SP with preauthorization
  • Trelegy Ellipta add Tier 3 with quantity limit
  • Tracleer solutab add Tier 3, with SP, preauthorization, quantity limit and age restriction
  • Prevymis tablet add Tier 3 with quantity versus time limit
  • Qvar Redihaler add Tier 2 with quantity limit
  • Steglatro tablet add Tier 3 with medical necessity preauthorization
  • Steglujan tablet add Tier 3 with medical necessity preauthorization
  • Solosec packet add Tier 3 with medical necessity preauthorization
  • Segluromet tablet add Tier 3 with medical necessity preauthorization

Preauthorization Update

  • Naprelan tablet, Fenortho capsule add medical necessity preauthorization
  • Victoza pen, Trulicity pen, Tresiba FlexTouch pen remove preauthorization

Step Therapy Update

  • Morphine sulfate extended release bead capsules, Duloxetine capsules, Seroquel tablets, MS Contin tablet, add step therapy
  • Aripiprazole tablets, Abilify tablets, Megace ES, Lyrica, Quetiapine extended release tablets, Seroquel XR tablets, Savella tablets, Saphris,  Fanapt tablet, Gralise tablet,  Exalgo tablet, Horizant tablet, Rexulti tablet, Vraylar capsule update step therapy

Quantity Limit Update

  • Saphris 10mg tablet, Latuda 80mg tablet, Latuda 120mg tablet add quantity limit

Tier Update

  • Arnuity Ellipta, Anoro Ellipta, with Tier update

Removed from Formulary

  • Enlon, Enlon-Plus, VSL #3 DS Packet

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

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

May: All States

May 2018. The following changes to the drug list are effective May 22, 2018:

Formulary Additions

  • Alunbrig tablet add Tier 4 with SP, preauthorization
  • Atazanavir capsule add Tier 1
  • Carvedilol extended release capsule add Tier 1 with quantity limit
  • Eliquis start pack add Tier 2
  • Erleada add Tier 4 with preauthorization
  • Estradiol Vaginal Cream 0.1mg/gm add Tier 1
  • Glatiramer 20mg/ml prefilled syringe add Tier 3 with SP, quantity limit, preauthorization
  • Glatiramer 40mg/ml prefilled syringe add Tier 3 with SP, quantity limit, preauthorization
  • Linzess 72mcg capsule add Tier 3 with quantity limit, step therapy
  • Roweepra XR tablet add Tier 1
  • Symdeko tablet add Tier 4 with SP, limited access, quantity limit, preauthorization
  • Tenofovir tablet add Tier 1
  • Xigduo XR tablet add Tier 2
  • Zenpep capsule add Tier 3

Quantity Limit Update

  • Linzess 145 mcg capsule, Linzess 290 mcg capsule – add quantity limit
  • Meloxicam 7.5mg tablet – remove quantity limit

Removed from Formulary

  • Coreg CR capsule; consider carvedilol extended release capsule
  • Doribax infusion
  • Estrace Vaginal Cream; consider Estradiol Vaginal Cream 0.1mg/gm
  • Glatopa; consider Glatiramer solution
  • Reyataz capsule; consider atazanavir capsule
  • Viread 300mg tablet; consider Tenofovir 300mg tablet

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

April: All States

April 2018. The following changes to the drug list are effective April 22, 2018:

Formulary Addition

  • Advair HFA add Tier 2
  • Advair Diskus add Tier 2
  • Anoro Ellipta add Tier 2
  • Arnuity Ellipta add Tier 2
  • Trelegy Ellipta add Tier 3 with quantity limit
  • Tracleer solutab add Tier 4 with SP, quantity limit, age restriction and preauthorization
  • Prevymis tablet add Tier 3 with quantity versus time limit
  • Qvar Redihaler add Tier 2 with quantity limit

Tier Update

  • Flovent HFA, Flovent Diskus with Tier update

Step Therapy Update

  • Gabapentin, Duloxetine capsule, Lyrica, Quetiapine ER tablet, Savella, Gralise, Horizant tablet, Rexulti tablet, Vraylar capsule, step therapy updated
  • Serevent Diskus, Budesonide inhalation suspension, Qvar, Foradil, Spiriva Handihaler, Flovent HFA, Flovent Diskus, Asmanex, Brovana, Symbicort, Perforomist, Pulmicort Flexhaler, Arcapta Neohaler, remove step therapy
  • Nucynta ER, Oxycodone ER tablet, Hydromorphone ER, Duloxetine capsule, tablet add step therapy

Removed from Formulary

  • Alvesco; consider Qvar Redihaler, Pulmicort, Asmanex, Flovent, Arnuity Ellipta
  • Dulera; consider Qvar Redihaler, Pulmicort, Asmanex, Flovent, Arnuity Ellipta
  • Mytelase

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 4/11/2018