Pharmacy Formulary Updates effective 10/1/2025
Date: 08/29/25
Medicaid Formulary Updates
Effective October 1, 2025
Effective October 1, 2025, Arizona Complete Health-Complete Care Plan (AzCH-CCP) will implement AHCCCS formulary changes based on the recommendations from the June 10, 2025, AHCCCS Pharmacy & Therapeutics (P&T) Committee Meeting.
To review the AzCH-CCP Preferred Drug Lists (PDLs) including the recent updates, visit our website at: www.azcompletehealth.com > For Providers > Pharmacy > Preferred Drug Lists.
We encourage prescribing clinicians to review our PDL for preferred formulary alternatives prior to prescribing. The table below highlights some of the upcoming formulary changes.
Preferred Products Added | Drug(s) Removed from Formulary | Utilization Management (PA, STEP, QL, AGE)** | *Continuation of Non-Formulary Medication Permitted (Y/N) | |
|---|---|---|---|---|
Analgesics, Long-Acting Narcotic | methadone tablet, methadone sol tablet, methadone solution, methadone concentration ) | Nucynta ER Xtampza ER (Manufacturer no longer participating in MDRP) |
PA | No |
Antimigraine Agents, Other | N/A | Ergotamine Tartrate/ Caffeine Cafergot (Manufacturer no longer participating in MDRP) |
PA, QL | No |
Antipsychotics, Atypical Long-Acting Injectable | Perseris (AHCCCS will continue to cover as long as supplies last) | Olanzapine IM Zyprexa IM | PA Required for Ages < 18 years or when not prescribed by a Behavioral Health Provider Uzedy is under review and a drug list status has not been determined | No |
COPD Agents | Tiotropium (Generic Spiriva Handihaler) | Spiriva Handihaler |
N/A | No |
Glucagon Agents | Baqsimi (Nasal), Zegalogue Syringe | Gvoke Pen, Gvoke Syringe, Gvoke Vial |
QL | No |
Drug Class | Preferred Products Added | Drug(s) Removed from Formulary | Utilization Management (PA, STEP, QL, AGE)** | *Continuation of Non-Formulary Medication Permitted (Y/N) | |
|---|---|---|---|---|---|
| Glucocorticoids, Inhaled | budesonide/formoterol (AG) Fluticasone/Salmeterol (Advair) (AG) (Inhalation) Fluticasone/Salmeterol (Advair) (Inhalation) | Advair Diskus Symbicort |
N/A | No |
| Growth Hormone | Genotropin Cartridge | N/A | PA
| No |
| Hypoglycemics (Insulin and Related Agents) | N/A | Humalog Cartridge Humalog Mix Vial Novolin 70/30 Vial OTC |
N/A | No |
| Hypoglycemics, Incretin Mimetics/Enhancers | Byetta Pens, Exenatide Pens (Byetta Generic) , liraglutide (AG for Victoza) | Kazano, Oseni (discontinued) Discontinued products are preferred as supplies last |
PA | No |
| Immunologics (Immunomodulators, Atopic Dermatitis and Immunomodulators, Asthma) | Fasenra pen/syringe, Vtama Cream 1%, Xolair Syringe/Vial, Zoryve 0.15% cream | Cinqair, Nucala Auto-Injector, Nucala Syringe, Nucala Vial, Tezspire Pen, Tezspire Syringe |
PA | No |
| Multiple Sclerosis Agents | Briumvi (INTRAV.) | N/A |
PA | Yes |
| Stimulants and Related Agents | Armodafinil (AG), Methylphenidate ER (Generic for Concerta), Modafinil | Armodafinil, Concerta, Nuvigil, Provigil, Sunosi, Wakix |
PA Methylphenidate ER only PA required for Ages < 6 years | No |
*AHCCCS P&T determines whether to permit continued use of a non-formulary medication. When not permitted, members must switch to the preferred formulary alternative and a new prescription may be required. See AHCCCS Policy AMPM 310-V.
**Prior Authorization (PA), Step Therapy (STEP), Quantity Limit (QL), Age Restriction (AGE), Authorized Generic (AG)
If you have questions, please contact the AzCH-CCP Pharmacy Team at (888) 788-4408 (Options 3, 7).
Thank you!