Medicaid formulary changes for select asthma drugs effective Aug. 1, 2019
In 2018, the Medicaid Common Formulary Workgroup made the decision to restrict coverage of Symbicort inhalers to patients age 0–12 years and remove coverage of Dulera inhalers, effective Jan. 1, 2019. However, due to a shortage in market availability of the formulary alternative, Fluticasone-Salmeterol (generic AirDuo RespiClick®), the Michigan Department of Health and Human Services and Michigan Medicaid Health plans agreed to continue coverage of Dulera and Symbicort for existing users through July 31, 2019.
Medicaid formulary changes effective Aug. 1, 2019
Effective Aug. 1, 2019, Medicaid coverage for Dulera® will end, and Symbicort® coverage will be restricted to patients aged 0–12 years.
By Aug. 1, 2019, Medicaid patients must switch to a covered medication or contact their provider to request continued coverage. Providers can switch patients at any time prior to Aug. 1, 2019. The following formulary alternatives are covered:
- Fluticasone-Salmeterol 55-14mcg, 113-14mcg, and 232-14mcg
- Fluticasone-Salmeterol and Wixela™ Inhub™ 100-50mcg, 250-50mcg, 500-50mcg
How we're communicating to our members
All members impacted by this change received a letter in June 2019. The letter advises the member of their upcoming drug coverage change and what steps they should take prior to Aug. 1, 2019.