2022 Priority Partners Formulary Changes

 

The table below outlines all the changes to our formulary since the formulary list was last printed on 01/01/2022.

 

 

Drug Name Description of Change* Copay Amount Effective Date
of Change
Kerendia (finerenone) Addition to formulary with PA $3 01/01/2022
Benlysta (belimumab) subcutaneous Addition to formulary with PA $3 01/01/2022
Lupkynis (voclosporin) Addition to formulary with PA $3 01/01/2022
Eucrisa (crisaborole) ointment Addition to formulary with PA $3 01/01/2022
Free Style Libre 14-Day Receiver and Sensor Addition to formulary with QL $0 01/01/2022

*QL = Quantity Limit, PA = Prior Authorization, ST = Step Therapy, NF = Non Formulary, N/A = Not Applicable