Updated July 2, 2026

Pharmacy Benefits Advisory Committee (PBAC) Updates

The Pharmacy Benefits Advisory Committee (PBAC), consisting of clinical subject matter experts within Michigan Medicine and the University of Michigan, meets regularly to review and approve changes to the Prescription Drug Plan formulary. Check the formulary for up to date formulary status. Formulary status is subject to change. Here are the latest updates.

September 2026

Effective Sept. 1, 2026, the following changes will be made to the Prescription Drug Plan’s formulary.

Coverage Updates

• Crinone 4% gel - Add QL
• Clomiphene - Add QL
• Simvastatin 40 mg tablet - update QL
• Juxtapid - Move to excluded
• Norpace CR - Move to NF
• Doxycycline hyclate DR 50, 75, 100, 150 mg tablet - Move to NF
• Doryx DR 60, 80 mg tablet - Move to excluded
• Doxycycline monohydrate 75 mg, 150 mg capsule - Move to NF
• Minocycline ER 45, 90, 135 mg tablet - Move to excluded
• Valproic acid 500 mg/10 mL cup - Move to excluded
• Metformin oral solution - Add AL
• Disulfiram 500 mg tablet - Move to excluded
• Xolegel - Move to NF
• Ketoconazole foam - Add ST
• Tobradex ST - Add ST
• Metronidazole lotion - Add ST
• Amzeeq - Move to NF
• Zilxi - Move to NF
• Galantamine oral solution - Add AL
• Amlodipine-valsartan-hctz - Move to NF
• Memantine titration pack - Move to excluded
• Memantine-donepezil - Move to NF
• Triamterene - Move to NF
• Calcipotriene 0.005% foam - move to NF
• Wynzora - Move to excluded
• Atropine 1% droperette - Add ST
• Promethegan 50 mg suppository - Move to excluded
• Deferiprone - Add PA
• Olmesartan-amlodipine-hctz - Move to NF

August 2026

Effective Aug. 1, 2026, the following changes will be made to the Prescription Drug Plan’s formulary.

New Products Added to Formulary

• Arynta - Tier 1, AL, QL
• Ozempic tablet - Tier 2, PA, AL, QL
• Wegovy HD - Tier 3, MMN, PA, QL
• Nereus - Tier 3, MMN, PA, QL
• Lifyorli - Tier 2, specialty, PMP, PA, QL
• Palsonify - Tier 3, specialty, PMP, PA, QL

Coverage Updates

• Pitavastatin - Move to Tier 0

July 2026

Effective July 1, 2026, the following changes will be made to the Prescription Drug Plan’s formulary.

New Product Added to Formulary

• Aqvesme - Tier 2, specialty, PMP, PA, QL

Coverage Updates

• Alendronate oral solution - Add AL
• Avanafil tablet - Remove AL, remove GL, add ST
• Desmopressin - Add QL
• Mirabegron (Myrbetriq) - Add ST (if younger than age 65)
• Omvoh - Move to non-formulary
• Pyrukynd - Move to PMP
• Repatha and Praluent - Change PA to ST
• Rhofade - Add ST
• Sildenafil, tadalafil, vardenafil tablet - Remove AL, remove GL
• Sumatriptan-naproxen - Move to excluded
• Tremfya - Move to Tier 3
• Vardenafil ODT - Move to excluded
• Voriconazole oral suspension - Add AL
• Zinc (Galzin) - Move to excluded

June 2026

Effective June 1, 2026, the following changes will be made to the Prescription Drug Plan’s formulary.

New Products Added to Formulary

• Cardamyst - Tier 3, PA, QL

• Crenessity 25 mg capsule - Tier 2, specialty, LDD, PA, QL

• Lasix Onyu - Tier 2, specialty, MMN, PA, QL

• Omlonti - Tier 3, ST, QL

• Redemplo - Tier 2, specialty, LDD, PA, QL

Coverage Updates

• Rhopressa and Rocklatan - Change PA to ST, Add QL

May 2026

Effective May 1, 2026, the following changes will be made to the Prescription Drug Plan’s formulary.

New Products Added to Formulary

• Brinsupri - Tier 2, specialty, PMP, PA, QL
• Pivya - Tier 3, specialty, LDD, PA, QL
• Blujepa - Tier 3, specialty, LDD, PA, QL
• Myqorzo - Tier 2, specialty, LDD, PA, QL
• Daybue Stix - Tier 2, specialty, LDD, PA, QL
• SPS suspension - Tier 1
• Orladeyo Pellet Packet - Tier 3, specialty, LDD, PA, QL
• Gomekli - Tier 2, specialty, PMP, PA, QL

Coverage Updates

• Basaglar - Move to excluded (other brands of insulin glargine U-100, such as Lantus, insulin glargine YFGN, and Rezvoglar, are still covered.)
• Carbinoxamine ER suspension - Move to Tier 1, AL, QL
• Toujeo - Move to excluded (unbranded insulin glargine U-300 still covered)
• Veltassa - Move to non-formulary

April 2026

Effective April 1, 2026, the following changes will be made to the Prescription Drug Plan’s formulary.

New Products Added to Formulary

• Fiasp - Tier 0
• Hyrnuo - Tier 2, specialty, LDD, PA, QL
• iLet - Tier 2, PA, QL
• Kirsty - Tier 0
• Komzifti - Tier 2, specialty, PMP, PA, QL, split fill
• Lyumjev - Tier 0
• Merilog - Tier 0
• Orlynvah - Tier 3, specialty, LDD, PA, QL
• Phyrago - Tier 3, specialty, LDD, PA, QL
• Subvenite oral suspension - Tier 3, PA, QL
• twiist - Tier 2, PA, QL
• Vraylar 0.5, 0.75 mg - Tier 3, ST, QL
• Wegovy tablet - Tier 3, MMN, PA, QL

Coverage Updates

• Caffeine Citrate 60 mg/3 mL oral - Add PA, QL
• Carglumic acid - Add PA, QL
• Insulin glargine U-300 - Remove PA
• Omnipod - Move to Tier 2
• Sprix - Move to non-formulary, add QL
• Synarel - Add PA, QL
• Teglutik - Add PA, QL
• Tobi Podhaler - Move to non-formulary, add QL

March 2026

Effective March 1, 2026, the following changes will be made to the Prescription Drug Plan’s formulary.

New Products Added to Formulary

• Rhapsido - Tier 3, specialty, PMP, PA, QL
• Leqselvi - Tier 2, specialty, PMP, PA, QL
• Lynkuet - Tier 2, PA, QL
• Zurnai - Tier 2, QL

Coverage Updates

• Lokelma - Remove PA

February 2026

Effective Feb. 1, 2026, the following changes will be made to the Prescription Drug Plan’s formulary.

New Products Added to Formulary

• Anzupgo - Tier 3, specialty, LDD, PA, QL
• Brynovin - Tier 2, ST, QL
• Doptelet sprinkle - Tier 3, specialty, MMN, PA, QL
• Enbumyst - Tier 2, specialty, MMN, PA, QL
• Inluriyo - Tier 2, specialty, PMP, PA, QL
• Koselugo sprinkle - Tier 2, specialty, PMP, PA, QL
• Wayrilz - Tier 3, specialty, PMP, PA, QL
• Zoryve 0.05% cream - Tier 2, specialty, PMP, PA, QL
• Jascayd - Tier 2, specialty, LDD, PA, QL

Coverage Updates

• Lizkmez - Move to Tier 3, AL

January 2026

Effective Jan. 1, 2026, the following changes will be made to the Prescription Drug Plan’s formulary.

Coverage Updates

• Ruconest - Move from Tier 2 to Tier 3