Pharmacy Formulary Changes Effective Jan. 1, 2024

Effective Jan. 1, 2024, Blue Cross Blue Shield of North Dakota (BCBSND) is making the following changes to the BCBSND Formulary, NetResults Formulary, and Health Insurance Marketplace Individual Small Group 4 tier and 6 tier Formularies.

Flovent – Manufacturer Removal from Market

GlaxoSmithKline has notified the United States Food and Drug Administration (FDA) of their decision to stop making brand name Flovent HFA (fluticasone propionate inhalation aerosol) and Flovent Diskus (fluticasone propionate inhalation powder). Effective Jan. 1, 2024, these products will no longer be preferred by BCBSND and will move to a non-preferred/non-formulary status.

Members currently using Flovent HFA or Flovent Diskus may require an alternative product. Specific coverage will vary by formulary, but preferred options may include Arnuity Ellipta (fluticasone furoate inhalation powder), Asmanex (mometasone furoate inhalation suspension), and Qvar (beclomethasone dipropionate inhalation aerosol).

Advair Diskus – Brand Name Formulary Removal

Beginning Jan. 1, 2024, generic fluticasone propionate/salmeterol inhalation powder and Wixela will be the preferred fluticasone propionate/salmeterol inhalation products on BCBSND formularies.

If pharmacies receive a prescription for Advair Diskus, they will need to submit a claim for generic fluticasone propionate/salmeterol inhalation powder or Wixela for the member to be assessed their generic cost share. Claims submitted for Advair Diskus may either be not covered, process at the preferred brand member cost share, or process at the non-preferred brand member cost share.

Victoza – Formulary Removal

Effective Jan. 1, 2024, Victoza will be placed in a non-formulary/non-preferred position. The following table exhibits preferred and non-preferred products after Jan. 1, 2024. All preferred and non-preferred agents require prior authorization.

Preferred Agents

Non-Preferred Agents

Mounjaro (tirzepatide)

Adlyxin (lixisenatide)

Ozempic (semaglutide)

Byetta (exenatide)

Rybelsus (semaglutide)

Victoza (liraglutide)

Trulicity (dulaglutide)

Narcan (naloxone) OTC Nasal Spray – Added to Formulary

Effective Jan. 1, 2024, Narcan and generic naloxone 4mg over the counter (OTC) nasal spray will be added as covered products on BCBSND formularies. Narcan and generic naloxone 4mg OTC nasal spray must be processed as a pharmacy claim for member benefits to apply.