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

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

Formulary Additions

  • Lynparza tablet add Tier 3 with SP, partial fill, limited access and preauthorization
  • Methylphenidate ER (LA) 10mg capsule add Tier 1 with quantity limit, preauthorization
  •  Methylphenidate ER 72 mg tablet add Tier 1 with quantity limit and preauthorization
  • VyLibra add Tier 0
  • Tri-VyLibra add Tier 0
  • Toujeo Max SoloStar add Tier 2
  • Zenpep 10000/32000/42000 capsule add Tier 3
  • Zenpep 15000/47000/63000 capsule add Tier 3
  • Zenpep 3000/1000/14000 capsule add Tier 3
  • Balcoltra add Tier 0
  • Auvi-Q auto injector add Tier 3 with quantity limit, medical necessity preauthorization
  • Crysvita add Tier 3 with preauthorization
  • Humira Pediatric Crohn’s starter kit add Tier 3 with SP, quantity limit, preauthorization
  • Jynarque tablet add Tier 3 with quantity limit, preauthorization
  • Osmolex ER tablet add Tier 3 with quantity limit and step therapy
  • Tavalisse tablet add Tier 3 with SP, preauthorization
  • Aimovig Auto-injector add Tier 3 with medical necessity preauthorization

Quantity Limit Update

  • Methylphenidate ER tablet, Concerta tablet, Emverm tablet update quantity limit

Tier Update

  • Elidel cream, Eucrisa cream, Clenpiq with Tier update

Step Therapy Update

  • Ala Scalp, Amantadine capsule, Amantadine capsule, Cloderm cream, Temovate, Triderm, Clobetasol (cream, ointment, solution, gel, lotion, foam, shampoo, emulsion foam), Clobetasol E cream, Elidel cream, ApexiCon E cream, Cutivate lotion, Derma-Smoothe/FS Body/Scalp, Dermasorb HC, Dermasorb TA,  with updated step therapy
  • Eucrisa add step therapy

Preauthorization Update

  • Matulane capsule, Elidel cream, Cordran cream,  add preauthorization
  • Tretinoin gel, Clindamycin-Tretinoin gel, Ziana gel, Atralin gel, Veltin gel, Eucrisa cream remove preauthorization

Removed from Formulary

  • Terazol 3 cream, Brevicon (28) tablet, Gildagia tablet, Aclovate cream

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

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

Formulary Additions

  • IBU tablet add Tier 1
  • Triamcinolone injection suspension 40 mg/ml add Tier 1
  • Tiagabine tablet add Tier 1
  • Hydrocortisone-Pramoxine 1-1% cream add Tier 1
  • Analpram-HC rectal cream add Tier 3
  • Lansoprazole dispersible tablet add Tier 1 with quantity limit
  • Palonosetron IV solution add Tier 1 with quantity limit
  • Ritonavir tablet Tier 1
  • Drospirenone-Ethinyl Estradiol-Levomefol tablet add Tier 0
  • Scopalamine patch add Tier 1
  • Ilaris solution add Tier 3 with SP, quantity limit and preauthorization
  • Rubraca tablet add Tier 3 with SP, quantity limit and preauthorization
  • Lamotrigine starter kit add Tier 3
  • Norethindrone-Ethinyl Estradiol-FE chewable tablet add Tier 0
  • Melodetta 24 Fe add Tier 3
  • Enbrel Mini add Tier 3 with SP, quantity limit and preauthorization
  • Heplisav-B add Tier 0
  • Rhopressa solution add Tier 3 with medical necessity preauthorization
  • Makena auto injector add Tier 3 with preauthorization
  • Imbruvica tablet add Tier 3 with quantity limit and preauthorization
  • Imbruvica capsule add Tier 3 with quantity limit and preauthorization
  • Daliresp tablet add Tier 3 with quantity limit
  • Tydemy tablet add Tier 3
  • Tasigna capsule add Tier 3 with SP, partial fill, quantity limit and preauthorization

Quantity Limit Update

  • Daliresp tablet add quantity limit
  • Qnasl update quantity limit

Tier Update

  • Gabitril tablet, Enbrel, Humira, Tasigna capsule, Norvir tablet with updated tier

Removed from Formulary

  • NeutraSal, SalivaMax

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

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

August: All States

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

Formulary Addition

  • Eucrisa cream add Tier 2 with step therapy
  • Zenpep 20000/63000/84000 capsule add Tier 3
  • Zenpep 10000/32000/42000 capsule add Tier 3
  • Zenpep 15000/47000/63000 capsule add Tier 3
  • Zenpep 3000/1000/14000 capsule add Tier 3
  • Clenpiq add Tier 0
  • VyLibra add Tier 0
  • Tri-VyLibra add Tier 0
  • Toujeo Max SoloStar add Tier 2
  • Balcoltra add Tier 0
  • Humira Pediatric Crohns starter kit add Tier 4 with SP, quantity limit, preauthorization
  • Jynarque tablet add Tier 4 with quantity limit, preauthorization
  • Osmolex ER tablet add Tier 3 with quantity limit, step therapy
  • Tavalisse tablet add Tier 4 with SP, quantity limit, preauthorization

Quantity Limit Update

  • Emverm tablet with updated quantity limit

Step Therapy Update

  • Amantadine, Betamethasone lotion, Flurandrenolide lotion, Betamethasone Dipropionate Augmented gel, Elidel cream, Nolix lotion with step therapy update

Preauthorization Update

  • Matulane capsule, Flurandrenolide (lotion, cream), Elidel cream, Desonate gel, Nolix lotion add preauthorization
  • Betamethasone lotion remove preauthorization

Tier Update

  • Elidel cream, Zenpep 5000/17000/24000, Zenpep 25000/79000/105000 with tier update

Removed from Formulary

  • Ranitidine capsule; consider Ranitidine tablet

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

July: All States

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

Formulary Addition

  • IBU tablet add Tier 1
  • Tiagabine tablet add Tier 1
  • Gabitril tablet add Tier 3 with quantity limit
  • Palonosetron IV solution add Tier 1 with quantity limit
  • Ritonavir tablet add Tier 1
  • Scopolamine patch add Tier 1
  • Rubraca tablet add Tier 4 with SP, quantity limit and preauthorization
  • Enbrel Mini add Tier 4 with SP, quantity limit and preauthorization
  • Imbruvica add Tier 4 with SP, quantity limit and preauthorization
  • Daliresp tablet add Tier 3 with preauthorization
  • Tasigna capsule add Tier 4 with SP, quantity limit and preauthorization

Quantity Limit Update

  • Tiagabine tablet, Aloxi solution update quantity limit

Tier Update

  • Gaitril tablet, Norvir tablet with tier update

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 7/23/2018