22-338 Medication Trend Updates and Formulary Changes - 1st Quarter 2022
Date: 04/25/22
This information applies to Physicians and Participating Physician Groups (PPGs).
For Medi-Cal, this information applies to Kern, Los Angeles, Riverside, Sacramento, San Bernardino, San Diego, San Joaquin, Stanislaus, and Tulare counties.
Review formulary changes and medication safety issues
Stay up to date with info about:
- New buprenorphine warning regarding dental issues.
- Changes to the Health Net* Commercial Formulary and Medi-Cal Preferred Drug List (PDL) for the first quarter of 2022.
FDA warns orally dissolving buprenorphine is associated with dental issues
The U.S. Food and Drug Administration (FDA) issued a warning that orally dissolving buprenorphine can cause dental problems including tooth cavities, infections, and tooth loss even in patients without prior dental problems. Buprenorphine, however, remains an important treatment option for opioid use disorder (OUD) and pain, and its benefits outweigh its risks.
The FDA is requiring a new warning be added to the prescribing information for orally dissolving buprenorphine products. Prescribing and patient information will include strategies to maintain or improve oral health while taking buprenorphine.
The FDA recommends that providers perform a baseline dental evaluation and ask patients about their oral health history before prescribing. Prescribers should counsel patients about potential dental problems and the importance of regular dental checkups and hygiene. For more information please download 1-12-2022 FDA Drug Safety Communication information.
Medication | Status | Health Net Formulary alternatives | Comments | |||
|---|---|---|---|---|---|---|
Commercial | Medi-Cal | Commercial (tier 1 or 2) | Medi-Cal |
| ||
Bylvay™ (odevixibat) | NF | Medical Benefit** | Ursodiol, antihistamine, rifampin, cholestyramine | Ursodiol, antihistamine, rifampin, cholestyramine | An ileal bile acid transporter (IBAT) inhibitor used to treat pruritis in patients 3 months of age and older with progressive familial intrahepatic cholestasis. | |
Livmarli™ (maralixibat) | NF | Medical benefit** | Ursodiol, antihistamine, rifampin, cholestyramine | Ursodiol, antihistamine, rifampin, cholestyramine | An ileal bile acid transporter (IBAT) inhibitor used to treat cholestatic pruritis in patients with Alagille syndrome (ALGS) 1 year of age and older. | |
Pharmacy help line
For more information regarding changes to the Health Net Commercial Formulary or Health Net Medi-Cal PDL, contact the proper pharmacy phone numbers listed below:
Product | Telephone number | Fax number |
|---|---|---|
Pharmacy Benefit (Medi-Cal Rx) | 800-977-2273 | 800-869-4325 |
Medical Benefit Drugs (Medi-Cal) | 877-277-0413 | 833-953-3436 |
Commercial Pharmacy Services | 800-548-5524, option #3 | 866-399-0929 |
Additional information
If you have questions regarding the information contained in this update, contact the applicable Health Net Provider Services Center within 60 days at:
Line of Business | Telephone Number | Provider Portal | Email Address |
|---|---|---|---|
EnhancedCare PPO (IFP) | 844-463-8188 | ||
EnhancedCare PPO (SBG) | 844-463-8188 | ||
Health Net Employer Group HMO, POS, HSP, PPO, & EPO | 800-641-7761 | ||
Medicare (Employer group) | 800-929-9224 | ||
Medi-Cal | 800-675-6110 | N/A |
**Prior authorization (PA) for new start only is required to verify member eligibility and that the member satisfies clinical protocols to ensure appropriate use of the medication.