Each July, the Priority Health Pharmacy and Therapeutics committee makes changes to the commercial group and individual formulary to align with industry and regulatory changes and to ensure our members have access to safe and effective drugs. Beginning Jul. 1, 2026, the following changes will take effect:
Pharmacy drug changes
- Dexcom G6 Continuous Glucose Monitor (CGM) will be removed from the market by the manufacturer
- Formulary alternatives include: Dexcom G7 and Freestyle Libre CGM products
Medical drug changes
- Lunsumio™will have Site of Service requirements added for commercial group and individual members new to treatment. Members already approved for Lunsumio will remain approved at their current treatment location for the duration of their authorization
SaveOn SP Program changes
The following drugs will be added to the SaveOn SP Program drug list:
| Alvaiz™ | Alyftrek® | Hyrnuo® | Inluriyo™ | Komzifti™ |
| Modeyso™ | Redemplo® | Wayrilz™ | Winrevair™ |
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The following drugs will be removed from the SaveOn SP Program drug list:
| Alprolix® | Attruby® | Enspryng® | Galafold® | Jaypirca® |
| Keveyis | Koselugo® | Krazati® | Lonsurf® | Nerlynx® |
| Ogsiveo® | Ojemda™ | Olumiant® | Onureg® | Plegridy® |
| Pyrukynd® | Retevmo® | Revlimid® | Revuforj® | Somatuline® Depot |
| Strensiq® | Taltz® | Tazverik® | Verzenio® | Vosevi® |
| Voydeya™ | Vyndaqel | Xospata® | Xtandi® |
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We’re notifying members
Impacted members will receive a letter advising them of these drug coverage changes and what steps they can take prior to Jul. 1, 2026. If an alternative medication is available, those options will be listed.
Brand to generic drug changes effective Apr. 21, 2026
The following brand to generic coverage changes are already in effect or will take effect Jul. 1, 2026 for commercial group and individual members. Because brand and generic drugs are interchangeable at pharmacies, no action is needed from providers or members.
- Farxiga® (5mg, 10mg) removed from commercial group and individual formulary effective Apr. 21, 2026
- Generic, dapagliflozin, is covered at Tier 1
- Xigduo® (5/500mg, 5/1000mg, 10/500mg, 10/1000mg) removed from commercial group and individual formulary effective Apr. 21, 2026
- Generic, dapagliflozin/metformin hydrochloride, was added to formulary at Tier 1 effective Apr. 21, 2026
- Xigduo 2.5mg/1000 mg tablet will be removed from commercial group and individual formulary effective Jul. 1, 2026
- Generic, dapagliflozin/metformin 2.5mg/1000mg hydrochloride, will be added to formulary at Tier 1 effective Jul. 1, 2026
Want more information?
These changes will be reviewed at our July 1 Formulary Updates Provider Webinar.