Pharmacy coverage changes

Drug status changes
Drug	Plan	Eff. Date	Policy and Additional Information
New-to-Market Drugs	Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial, Tufts Health Direct	4/1/26	Non-Formulary Exceptions New-to-market Pharmacy benefit drugs will be excluded from coverage. For members with a life-threatening condition, exceptions requests may be granted in accordance with the criteria identified on the Non-Formulary Exceptions Pharmacy Medical Necessity Guidelines. Editor's note: this initiative was delayed to a June 1, 2026 effective date.
Drugs moving to non-formulary status
Drug	Plan	Eff. Date	Policy and Additional Information
Tresiba	Harvard Pilgrim Health Care Commercial, Tufts Health Plan Commercial	4/1/26	Tresiba Tresiba will be moved to non-formulary status on the Select and Value formularies.