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December 2021
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Market Edge
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News for All Segments | All brands
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Upcoming Select and Value Formulary changes effective January 1
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Beginning January 1, 2022, a change is being made to drugs for commercial plan members utilizing the Select Drug Program and Value Formulary.
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Proair® HFA and Proair® Respiclick® inhaler will no longer be the preferred short‑acting beta2‑adrenergic agonists (SABA) on the Select Drug Program and on the Value Formulary. On the Select Drug Program and Value Formulary, Proair® HFA will be non‑preferred. The generic of Proair® HFA, albuterol HFA aerosol, is available. This drug is used for the treatment or prevention of bronchospasm in patients 4 years of age and older with reversible obstructive airway disease, and prevention of exercise-induced bronchospasm in patients 4 years of age and older.
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Ajovy® will become non‑preferred on the Select Drug Program and will require a prior authorization. It will be non‑formulary on the Value Formulary. The preferred calcitonin gene‑related peptide antagonists are Aimovig® and Emgality®. Ajovy is an injectable calcitonin gene‑related peptide antagonist indicated for the preventive treatment of migraine in adults.
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Updates to Select and Value Drug Program® Formularies
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We routinely update our prescription drug formularies and review the list of drugs requiring prior authorization as part of our procedures for safe prescribing. These changes are approved by our Pharmacy and Therapeutics Committee.
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Please view the list of changes to the Value Drug Program Formulary and the Select Formulary for AmeriHealth New Jersey.
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You can also view the changes to the Select Formulary for AmeriHealth Administrators plans that require prior authorization and those that do not require prior authorization.
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All of these formulary changes are effective January 1, 2022.
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Standard bi‑annual changes include:
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- Additions of generic drugs to both Select and Value formularies
- Additions to the list of drugs requiring prior authorization on both Select and Value formularies
- Deletions to the list of drugs requiring prior authorization on both Select and Value formularies
- Deletions of brand and generic drugs on the Value formulary
- Moving drugs from a lower tier to a higher tier on both Select and Value formularies
- Moving drugs from a higher tier to a lower tier on both Select and Value formularies
- Addition of quantity and/or age limits to drugs on both the Select and Value formularies
- Changes to the prior authorization requirements for drugs on the Select and Value formularies
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Members who are impacted by these changes, as well as their providers, received letters in October — 60 days in advance of their effective date. Members are encouraged to discuss switching to the preferred products with their providers in order to avoid any disruption in their therapies.
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Please reach out to your account representative if you have any questions.
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