Effective for dates of service beginning Oct. 1, 2026, Point32Health is making substantial drug status and formulary updates, which will impact Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, and Tufts Health Direct members. 

Most notably, we will no longer provide coverage for drug products that are explicitly over-the-counter (OTC) or are prescriptions that have OTC equivalents, such as: 

  • 2nd generation antihistamines
  • H2 blockers
  • Nasal steroids
  • Prescription fluoride 
  • Proton pump inhibitors 

In instances where the drug product is a pediatric formulation, has no OTC equivalent, and/or is needed for benchmarking/mandated by the Affordable Care Act, the product will remain on the relevant formularies. 

Oct. 1, 2026 drug status and formulary updates 

Please refer to this document to review the drug status and formulary changes in detail. Changes include:

  • Drugs moving to non-formulary status
  • Over the counter drugs moving to excluded status
  • Prescription drugs moving to excluded status