MedicaidMarch 4, 2025
Quarterly pharmacy formulary change notice
The formulary changes in the table below were reviewed and approved at our fourth quarter 2024 Pharmacy and Therapeutics Committee meeting.
Effective March 1, 2025, the changes outlined below apply to all Anthem members.
Effective for all patients on March 1, 2025 | |||
Therapeutic class | Drug | Revised status | Potential alternatives |
DERMATOLOGICALS
| COSENTYX 300MG SENSOREADY PEN COSENTYX 150MG SENSOREADY PEN COSENTYX 150MG/ML INJECTION COSENTYX 300MG INJECTION COSENTYX 75MG/0.5ML INJECTION COSENTYX 125MG/5ML INJECTION COSENTYX UNO 300MG/2ML INJECTION | NON‑PREFERRED | SELARSDI INJECTION (PA REQUIRED) |
INTERLEUKIN ANTAGONISTS
| SELARSDI INJECTION | PREFERRED WITH PA | N/A |
PHOSPHODIESTERASE 4 (PDE4) INHIBITORS | OTEZLA STARTER KIT OTEZLA 10/20MG TABLET OTEZLA 30MG TABLET | NON‑PREFERRED | SELARSDI INJECTION (PA REQUIRED |
SOLUBLE TUMOR NECROSIS FACTOR RECEPTOR AGENTS
| ENBREL MINI 50MG/ML INJECTION ENBREL SURECLICK 50MG/ML INJECTION ENBREL 25MG/ML INJECTION ENBREL 50MG/ML INJECTION | NON‑PREFERRED | SELARSDI INJECTION (PA REQUIRED |
What action do I need to take?
Please review these changes and work with your Anthem patients to transition them to formulary alternatives. If preferred formulary alternatives are not clinically appropriate for specific patients, you will need to obtain preapproval to continue coverage beyond the effective date.
What if I need assistance?
If, for medical reasons, your Anthem patient cannot be converted to a formulary alternative, call our Pharmacy department at 844‑396‑2330 and follow the voice prompts for pharmacy preapproval. You can find the Preferred Drug List on our care provider partners website at https://providers.anthem.com/nv.
If you need assistance with any other item, contact your local Provider Relations representative or contact Provider Services at 844‑396‑2330.
Anthem Blue Cross and Blue Shield Healthcare Solutions is the trade name of Community Care Health Plan of Nevada, Inc. Independent licensee(s) of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
NVBCBS-CD-078422-25
PUBLICATIONS: April 2025 Provider Newsletter
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