Medicaid common formulary changes as of Oct. 1, 2017

The Michigan Department of Health and Human Services has worked with its health plan partners to create a list of drugs that all Medicaid health plans must cover. This list is called the Michigan Medicaid Managed Care Common Formulary.

For your reference, the Medicaid common formulary can be found at michigan.gov. Search for "Managed Care Common Formulary."

Changes effective Oct. 1, 2017

Lantus®

  • Lantus® is moving to non-formulary
  • Basaglar® Kwikpen is the formulary alternative

Patients taking Lantus® can continue to receive these medications until 09/30/2017. By October 1, they need to switch to a covered medication or contact you to request additional coverage for them.

Spiriva® and Tudorza®

  • Spiriva® and Tudorza® are moving to non-formulary
  • Incruse® Ellipta® is the formulary alternative

Patients taking Spiriva® and Tudorza® can continue to receive these medications until 12/31/2017. By January 1, they need to switch to a covered medication or contact you to request additional coverage for them.

Brand-name DPP4 drugs

Brand-name DPP4's will require a trial with Alogliptin as part of the PA criteria.

Patients taking brand-name DPP4's can continue to receive these medications until 09/30/2017. By October 1, they must switch to Alogliptin or contact you to request additional coverage for them.

Providers who had members affected by this change should have received a letter in September outlining the changes above.

Requesting coverage determinations or formulary exceptions

Call our Pharmacy team toll-free at 800.466.6642. We are open from 8:00 a.m. to 7:00 p.m., Monday through Friday and from 8:30 a.m. to 12:00 p.m. on Saturday. You may also fax your request toll-free to 877.974.4411.