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

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 Update

  • 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. 

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

Formulary Additions

  • Coly-Mycin M add Tier 3
  • Hydroxyprogesterone Caproate injection add Tier 1 with SP and preauthorization
  • Oralone paste add Tier 1
  • Triamcinolone paste add Tier 1
  • Minocycline extended release tablet add Tier 1 with medical necessity preauthorization
  • Diclofenac epolamine 1.3% patch add Tier 1 with quantity limit and medical necessity preauthorization
  • Calcium Acetate (phos binder) add Tier 1
  • Pertzye capsule add Tier 3 with medical necessity preauthorization
  • Minolira tablet add Tier 1 with medical necessity preauthorization
  • Symjepi prefilled syringe add Tier 2 with quantity over time limit
  • Azesco tablet add Tier 3 with medical necessity preauthorization
  • Alyq tablet add Tier 1 with SP and preauthorization
  • Motegrity tablet add Tier 3 with medical necessity preauthorization
  • Qmiiz ODT tablet add Tier 3 with medical necessity preauthorization

Step Therapy Update

  • Silenor tablet - add step therapy

Preauthorization Updates

  • Esbriet tablet remove medical necessity preauthorization

Removed from Formulary

  • Phenazopyridine tablets, Eliphos tablet

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

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

June: All States

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

Formulary Addition

  • 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. 

May: All States

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

Formulary Addition

  • Hydroxyprogesterone caproate injection add Tier 4 with SP and preauthorization
  • Oralone paste add Tier 1
  • Triamcinolone paste add Tier 1
  • Esbriet capsule add Tier 4 with SP, quantity limit and preauthorization
  • Ofev capsule add Tier 4 with SP, quantity limit and preauthorization
  • Makena injection add Tier 4 with SP and preauthorization
  • Symjepi prefilled syringe add Tier 2 with quantity over time limit
  • Alyq tablet add Tier 3 with SP and preauthorization

Preauthorization Update

  • Desonide ointment– remove preauthorization

Removed from Formulary

  • Cialis 2.5mg and 5mg tablet; consider tadalafil 2.5mg or 5mg 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 5/16/2019