Upcoming CareFirst Formulary Updates Effective April 1 and May 1, 2022

CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. (CareFirst) strives to provide affordable, accessible care to our members. We know that any increases in pharmacy spending have the potential to be transferred to our subscribers in the form of higher healthcare costs or offset by lower payments to our valued provider partners. To prevent unnecessary increases, we conduct a quarterly review of our formularies and make changes to encourage utilization of safe and clinically cost-effective drugs. We are mindful not to introduce additional administrative burden to our networks as a result of these changes.

A summary of changes effective April 1, 2022 for commercial Formularies 1, 2, 3 and 4, and May 1, 2022 for the Exchange Formulary, is available for your review.

These updates apply to your patients with CareFirst prescription benefits. Formulary updates may include drug additions, utilization management changes, changes to drug tiers, and/or removal of medications.

Having strong safeguards in place to manage pharmacy spending also benefits providers in value-based contracting arrangements.