Back to Insights and Updates for ProvidersSeptember 2024

Pharmacy coverage changes

Harvard Pilgrim Health Care Commercial  |  Tufts Health Direct  |  Tufts Health Plan Commercial  |  Tufts Health RITogether

Updates to existing prior authorization programs
Drug Plan Eff. date Policy & additional information
Forteo (teriparatide), Teriparatide (teriparatide), Tymlos (abaloparatide) Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, Tufts Health Direct 11/1/2024 Parathyroid Hormones
Repatha, Praluent, Nexletol, Nexlizet Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, Tufts Health Direct 11/1/2024 Lipid Lowering Agents
Vowst (fecal microbiota spores, live-brpk) Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, Tufts Health Direct 8/13/2024 Vowst (fecal microbiota spores, live-brpk)
Nexletol (bempedoic acid) and Nexlizet (bempedoic acid/ezetimibe) Tufts Health RITogether 11/1/2024 Nexletol (bempedoic acid) and Nexlizet (bempedoic acid/ezetimibe)
Proton Pump Inhibitors (PPIs) Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, Tufts Health Direct 11/1/2024 Proton Pump Inhibitors (PPIs)
Tarpeyo Tufts Health RITogether 11/1/2024 Tarpeyo