Medicaid Formulary Change: October 10, 2017

  • Effective October 10, 2017, Lantus (insulin glargine) will no longer be a covered medication on the Medicaid formulary.
  • Effective October 10th, Basaglar (insulin glargine) KwikPen will be the ONLY insulin glargine covered on the Medicaid formulary.

Formulary

Non-Formulary

Basaglar KwikPen*

Lantus vials

Lantus SoloStar

 

*Covered on Formulary with a Quantity Limit 30 mL. Prior Authorization is required for quantities greater than 30ml per Rx.

The Neighborhood Medicaid Formulary applies to members under the following plans: ACCESS and TRUST.

Below is a summary comparison of Basaglar formulary status across all Neighborhood formularies:

Formulary Formulary Status as of 10-10-2017 Note(s)
Medicaid Formulary Quantity Limit = 30ml per 30 days (PA required for >30ml)
Exchange Formulary, Tier 2/Preferred Brand Quantity Limit = 30ml per 30 days (PA required for >30ml)
INTEGRITY Non-Formulary Formulary as of January 1st, 2018

The Neighborhood Formulary for these plans can be found on the Pharmacy Resources page.