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.
Medical Pharmacy
The following Commercial prior authorization medical drug policies are new and effective Aug. 1, 2026:
*see www.gatewaypa.com/policydisplay/52 on or after Aug. 1, 2026.
- Armlupeg (pegfilgrastim)
- Boncresa (denosumab-mobz)
- Jubereq (denosumab-desu)
- Nufymco (ranibizumab-leyk)
- Osvyrti (denosumab-desu)
- Oziltus (denosumab-mobz)
Retail Pharmacy
The following retail pharmacy Utilization Management (UM) programs are new and effective Aug. 1, 2026:
*see www.myprime.com/en/forms.html on or after Aug. 1, 2026.
- Aqvesme
- Commercial, HIM, NetResults
- Cardamyst
- NetResults
The following retail pharmacy Utilization Management (UM) programs have updates effective Aug. 1, 2026:
*see www.myprime.com/en/forms.html on or after Aug. 1, 2026.
UM Program Name | Program Type | Formulary | Update for Provider Letter |
Filspari | PAQL | Commercial, HIM, NetResults | *Clinical criteria update |
