Administrative bulletin: 2026-07-004 Pharmacy updates


Date: July 1, 2026

Effective date: July 1, 2026

Topics covered in this administrative bulletin are applicable to:

Professional and facility Providers

Professional and facility Providers


Capital Blue Cross formulary update – Dapagliflozin replaces Farxiga

  • CHIP
  • EPO
  • FEP PPO
  • HMO
  • Medicare Advantage HMO
  • POS
  • PPO
  • Traditional and Comprehensive
  • Medicare Advantage PPO

KEY POINT: Effective July 1, 2026, Farxiga has been removed, and the alternative, dapagliflozin has been added to the Capital Blue Cross Elite and Exclusive, Advantage, and Value Plus Formularies.

The following update reflects a change to previously published information regarding Capital’s July formulary updates. For the complete list, please refer to the May 2026 publication, Administrative bulletin 2026-05-004 Pharmacy updates.

Capital Blue Cross Formulary update

KEY: (PA) = Prior Authorization; (ST) = Step therapy; (QLL) = Quantity Level Limits lowercase bold print = generic; UPPERCASE PRINT = BRAND Formulary Status: Generic Preferred (GP), Generic Non-Preferred (GNP), Brand Preferred (BP), Brand Non-Preferred (BNP), Nonformulary (NF)

Removed from formulary effective July 1, 2026

Brand name

Tier status

Indication

Preferred alternative

FARXIGA

BP

Antidiabetes

dapagliflozin (ST, QLL)