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June 2021
Starting July 1, we’ll change how we cover some drugs on the Preferred Drug List
Action item:
Be aware of drugs that we no longer cover — and prescribe preferred alternatives when possible.
Blue Cross Blue Shield of Michigan and Blue Care Network are committed to ensuring members receive safe, high-quality care that meets their needs. To accomplish this, we’re making some changes to how we cover some drugs on the Preferred Drug List, starting July 1, 2021:
- We’ll no longer cover the brand-name and generic drugs list in the table below.
- If a member fills a prescription for one of the drugs listed in the table below on or after July 1, they’ll be responsible for the full cost.
- The list below shows suggested preferred alternatives that have similar effectiveness, quality and safety.
- Unless noted, we won’t cover both the brand-name and available generic equivalents.
- The example brand names of preferred alternatives are for your reference.
- When a prescription is filled, the generic equivalent is dispensed, if available.
| Drugs no longer covered |
Common use or drug class |
Preferred alternatives |
| Afrezza® |
Diabetes |
Fiasp® (all forms), Novolin® (with National Drug Codes ending in 00, 01, 11, or 15), NovoLog® (all forms) |
| Annovera®, Balcoltra®, Lo Loestrin® Fe, Natazia® |
Contraceptives |
Generic oral and ring contraceptives, Xulane® patches |
| Apokyn® |
Parkinson’s disease |
Kynmobi™ |
| Besivance® |
Ophthalmic anti-infective |
Ciloxan® drops, Garamycin®, Ocuflox®, Quixin®, Vigamox®, Zymaxid® |
| Betimol®, Rhopressa®, Rocklatan® |
Glaucoma |
Alphagan®, Azopt®, Betagan®, Betopic®, Combigan®, Cosopt® PF, Istalol®, Lumigan®, Ocupress®, Optipranolol®, Timoptic®, Travatan Z®, Trusopt®, Xalatan®, Zioptan® |
| Bijuva®, Premphase®, Prempro® |
Estrogen and progestin combinations (oral) |
Activella®, Femhrt® |
| Bystolic®, Corlanor® |
Cardiovascular conditions |
Cardioselective beta-blockers (such as Lopressor®, Tenormin, Toprol XL) |
| Clenpiq®, GoLYTELY® packets, Plenvu®, SUPREP® |
Bowel preparation |
Colyte®, GoLYTELY, GlycoLax® OTC, NuLYTELY®, PEG-Prep® |
| DALIRESP® |
Chronic obstructive pulmonary disease |
Combination products:
Advair® HFA, Anoro Ellipta,
Bevespi Aerosphere®, Breo Ellipta,
Breztri Aerosphere®, Dulera®, fluticasone and salmeterol (by Prasco or Proficient Rx), Stiolto® Respimat®, Symbicort®, Trelegy® Ellipta®, Yupelri®
Single ingredient products:
Arnuity® Ellipta®, Asmanex® HFA, Flovent® HFA, Flovent Diskus, Incruse® Ellipta®, Perforomist®, QVAR Redihaler®, Serevent® Diskus®, Spiriva® Respimat® |
| Divigel®, Evamist®, Estring®, Imvexxy®, Menest®, Osphena®, Premarin® tablets |
Menopause symptoms |
Climara®, Estrace®, Minivelle®, Premarin® cream, Vivelle-Dot®, Vagifem® |
| Drysol™ |
Hyperhidrosis |
Over-the-counter antiperspirants |
| EDARBI® |
Hypertension |
Atacand®, Avapro®, Benicar®, Cozaar®, Diovan®, Micardis® |
| EDARBYCLOR® |
Hypertension |
Atacand® HCT, Avalide®, Benicar® HCT, Diovan® HCT, Hyzaar®, Micardis® HCT |
| Envarsus XR® |
Organ rejection prophylaxis |
Prograf® |
| Flarex® |
Ophthalmic steroid |
Decadron® ophthalmic, FML®, Inflamase® Forte, Inveltys®, Pred Forte®, Lotemax® |
| Pexeva®, Viibryd® |
Depression |
Celexa®, Cymbalta®, Effexor®, Effexor XR, Elavil®, Lexapro®, Luvox®, Luvox CR, Paxil®, Paxil CR, Pristiq®, Prozac®, Wellbutrin® SR, Wellbutrin XL, Zoloft® |
| Pulmicort Flexhaler® |
Inhaled steroids |
Arnuity® Ellipta®, Asmanex® HFA, Flovent® HFA, Flovent Diskus, QVAR Redihaler |
| QNASL® |
Nasal steroids |
Flonase®, Nasalide®, Nasonex® |
| Slynd® |
Contraceptives |
Ortho Micronor®, Nor-QD® |
| Tirosint®, Tirosint®-SOL |
Thyroid replacement therapy |
Synthroid® |
| Tobradex® ST, ZYLET® |
Ophthalmic anti-infective and steroid |
Tobradex® suspension, Tobradex ointment |
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