Advantage and Value Plus formulary update
4th quarter 2020
The Capital Blue Cross formulary is a reference list of prescription drugs that contains a wide range of generic and brand drugs that have been approved by the U.S. Food and Drug Administration (FDA). The formulary is updated on a quarterly basis or when new generic or brand-name medications become available and as discontinued drugs are removed from the marketplace.
The Advantage and Value Plus formularies were created by Capital Blue Cross to give members access to quality, affordable prescription drugs and to provide physicians with a list of preferred drugs for cost-effective prescribing.
Several new drugs have come to market and are now included in our formulary.
Pharmacy Management Program update
(PAR) = Prior Authorization Required
(ST) = Step Therapy Required
(QLL) = Quantity Level Limits Apply — Quantity Level Limit (QLL) Program
(BP) = Brand Preferred
(BNP) = Brand Non-Preferred
(NC) = Not Covered
(NF) = Non-Formulary
UPPERCASE names = Brand
lowercase names = Generic
1Indicates specialty medication
2Split Fill Program available
3Impacted members will be notified prior to change.
The information contained on this page is not all encompassing and is subject to change. Please refer to your Certificate of Coverage for specific terms, conditions, exclusions and limitations relating to your coverage.