Notable Medicare Pharmacy Changes for 2024
Notable pharmacy changes for Medicare plans coming in 2024
- PBM will be moving from CVS to Express Scripts in 2024 for all Medicare plans. Members have been sent new ID cards with new pharmacy billing information.
- Prior Authorizations will be required for GLP-1 agonists in 2024
- The following table shows the most frequently prescribed drugs that will be non-formulary and their preferred alternatives in 2024:
TOP DRUG REMOVALS WITH ALTERNATIVES (Medicare Plans Only) | ||
DRUG(S) REMOVED | FORMULARY ALTERNATIVES | |
All MAPD Plans | ||
Lantus vial; Lantus SoloStar insulin pen | Basaglar KwikPen insulin pen; Toujeo SoloStar insulin pen; Toujeo Max SoloStar insulin pen; Tresiba vial; Tresiba FlexTouch insulin pen | |
Levemir vial; Levemir FlexPen insulin pen | ||
Victoza pen injector | Bydureon Bcise auto-injector; Mounjaro pen injector; Ozempic pen injector; Rybelsus tablet; Trulicity pen injector | |
Byetta pen injector | ||
Flovent Diskus inhalation device; Flovent HFA inhaler | (Discontinued by manufacturer) | Arnuity Ellipta inhalation device; Pulmicort Flexhaler aerosol powder |
Betoptic-S suspension eye drops | Alphagan P 0.1% eye drops; Brimonidine Tartrate eye drops; Combigan eye drops | |
Kevzara pen injector; Kevzara syringe | Enbrel injection; Humira injection; Rinvoq tablet; Xeljanz tablet; Xeljanz XR tablet (diagnosis dependent) | |
Ingrezza capsule | Austedo tablet; Tetrabenazine tablet | |
Mavyret tablet; Mavyret pellets in packet | No impact for current utilizers; Epclusa tablets; Epclusa pellets in packet; Harvoni tablets; Harvoni pellets in packet | |
D-SNP and MMP Only | ||
Simbrinza suspension eye drops | Alphagan P 0.1% eye drops; Brimonidine Tartrate eye drops; Combigan eye drops | |
Vyzulta eye drops | ||