Blue Cross Blue Shield of North Dakota (BCBSND) continually develops and revises pharmacy policies in response to rapidly changing pharmaceutical requirements. Our commitment is to update the provider community as pharmacy policies are adopted and/or revised.
The following retail pharmacy Utilization Management (UM) programs have updates effective May 1, 2026:
*see www.myprime.com/en/forms.html on or after May 1, 2026
UM Program Name | Program Type | Formulary | Updates for Provider Letter |
PCSK9 Inhibitors | PAQL | Commercial, HIM, NetResults | *Clinical criteria update and standardized wording and format of language |
Retail pharmacy administrative actions:
UM Program Name | Program Type | Formulary | Summary of Changes |
Alternative Dosage Form | PAQL | NetResults | Addition of Sdamlo, Ontralfy and Pokonza as targets |
Weight Management | PAQL | Commercial, HIM, NetResults | Addition of Zepbound Kwikpen |
