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Drug Changes


Here you will find a listing of the drugs that have been changed on our drug list (formulary) for the plan year you select.

To request Medicare Part D prescription drug coverage determinations (including tiering or formulary exception requests) please use the following form:


Denavir Cream 1 % External


Post Date:
2/1/2023
Effective Date:
2/1/2023
Type of Change:
Drug removed
Reason Changed:
Generic therapeutically equivalent product available
Applies To:
All Rx Plans

Alternative Drugs


Drug Tier* Drug Restrictions Therapy Class
Penciclovir Cream 1 % External Tier 2 ST Topical Anti-infectives
* Please reference your Evidence of Coverage for applicable cost-sharing.

Tazorac Gel 0.05 % External


Post Date:
2/1/2023
Effective Date:
2/1/2023
Type of Change:
Drug removed
Reason Changed:
Generic therapeutically equivalent product available
Applies To:
All Rx Plans

Alternative Drugs


Drug Tier* Drug Restrictions Therapy Class
Tazarotene Gel 0.05 % External Tier 4 Acne and Rosacea Agents
* Please reference your Evidence of Coverage for applicable cost-sharing.

Tazorac Gel 0.1 % External


Post Date:
2/1/2023
Effective Date:
2/1/2023
Type of Change:
Drug removed
Reason Changed:
Generic therapeutically equivalent product available
Applies To:
All Rx Plans

Alternative Drugs


Drug Tier* Drug Restrictions Therapy Class
Tazarotene Gel 0.1 % External Tier 4 Acne and Rosacea Agents
* Please reference your Evidence of Coverage for applicable cost-sharing.