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Lowest Net Cost Formulary Update Bulletin - Effective April 1, 2026
The changes in this update apply to all groups that use OptumRx
The majority of these updates include decisions that occurred as a result of the November 2025 Pharmacy and Therapeutics Committee (P&T) meeting. Members impacted by these changes were sent a notification letter in February.
FORMULARY UPDATES
Additions
These drugs will be added to the formulary effective April 1, 2026:
| Product | Drug Class/Category | Utilization Management Programs | Formulary Status |
| Andembry | Hereditary Angioedema | PA/QL | Nonpreferred Specialty |
| Avmapki Fakzynja Copack | Oncology | PA | Nonpreferred Specialty |
| Ekterly | Hereditary Angioedema | PA/QL | Nonpreferred Specialty |
| Emrelis | Oncology | PA | Nonpreferred Specialty |
| Ibtrozi | Oncology | PA | Nonpreferred Specialty |
| Lynozyfic | Oncology | PA | Nonpreferred Specialty |
| Yeztugo | HIV (PrEP) | QL | Nonpreferred Specialty |
| Zusduri | Oncology | PA | Nonpreferred Specialty |
Exclusions
These drugs will move to non-formulary status and be excluded from coverage effective April 1, 2026:
• Activella Tab 1-0.5mg
• Acular Sol 0.5% Op-
• Cipro Tab
• Copaxone Inj
• Cosopt Sol 2-0.5%Op
• Daraprim Tab 25mg
• Kaletra Tab
• Livalo Tab
• Lomotil Tab 2.5mg
• Maxitrol Sus 0.1% Op
• Sandostatin Kit Lar 30mg
• Vigamox Dro 0.5%