Sorry, you need to enable JavaScript to visit this website.
Skip to main content
shield icon covid 19

Great news for members: OHSU and PeaceHealth stay in-network. Learn more.

×

Additional June 22nd Drug List Changes (Commercial)

Updates on Existing Criteria

June 2025. The following changes to criteria are effective June 22nd, 2025:

Prior Authorization Criteria – Clinical Updates

  • Targeted Immune Modulators – add Selarsdi and Yesintek to the Preferred Drugs and Preferred Medical Drugs lists 

 

Preferred Drug List (PDL) Changes

June 2025. The following changes to the drug list are effective June 22, 2025:

Prior Authorization

  • Remove Medical Necessity
    • Selarsdi injection
    • Yesintek injection 

 

State Based Drug List (OR, ID, MT, WA) Changes

June 2025. The following changes to the drug list are effective June 22, 2025:

Formulary Additions

  • Selarsdi injection add tier 4 with SP and prior authorization
  • Yesintek injection add tier 4 with SP and prior authorization

 

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