Medicaid Formulary Updates effective 1.1.2025
Date: 11/29/24
FORMULARY UPDATES
Effective 01/01/2025
Effective January 1st, 2025, Arizona Complete Health-Complete Care Plan (AzCH-CCP) will implement AHCCCS formulary changes based on the recommendations from the October 15, 2024, AHCCCS Pharmacy & Therapeutics (P & T) Committee.
To review the AzCH-CCP Preferred Drug Lists including the recent updates, visit our website at: www.azcompletehealth.com > For Providers > Pharmacy > Preferred Drug Lists.
We encourage all prescribing clinicians to review our Preferred Drug Lists (PDL) for preferred formulary alternatives prior to prescribing. The table below highlights some of the upcoming Formulary changes.
| Drug Class | Preferred: | Non-Preferred | *Grandfathering permitted (Y/N) | Additional Requirements: |
| Anticonvulsants | Diastat (Rectal)* | |||
| Antifungals - Oral | Voriconazole tablets (oral) | No | ||
| Antimigraine | Eletriptan (oral) | Sumatriptan Kit (Subcutane) | No | |
| Beta Blockers | Nebivolol | |||
| Contraceptives – Combined Pill | Gemmily (oral) Iclevia (oral) Low-ogestrel (oral) Microgestin 24 FE (oral) Nymyo (oral) Tyblume (oral) Vestura (oral) | No | ||
| Contraceptives – Emergency | Aftera OTC Plan B One-Step OTC Take Action OTC | No | ||
| Contraceptives – Progestin – Oral | Opill OTC | |||
| Contraceptives – Progestins- Transdermal | Twirla Zafemy | No | ||
| HAE Treatments | Haegarda (sub-Q) | No | ||
| HIV – AIDS | Maraviroc Tablet (oral) | Selzentry tablet (oral) Truvada (oral) Viread Powder (oral) | No |
*AHCCCS P&T determines whether to permit grandfathering (continued use of a non-formulary medication). If grandfathering is not permitted, members will need to switch to the preferred formulary alternative and a new prescription may be required. (See AHCCCS Policy 310-V)
** Prior Authorization (PA), Step Therapy (STEP), Quantity Limit (QL), Age Restriction (AGE), Authorized Generic (AG)
For AzCH-CCP questions: Contact the pharmacy team (888)
788-4408 (Options 3, 7)
Thank you!