Upcoming CareFirst Formulary Updates Effective July 1, 2025
At CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. (collectively, CareFirst), our mission to advance affordable, accessible, equitable, high-quality healthcare guides every decision we make. We understand that changes in pharmacy spending can affect both our members and our valued provider partners. To ensure the best outcomes, we regularly review our formularies and make adjustments to promote the use of clinically appropriate and effective medications. Formulary updates may include drug additions, utilization management changes, changes to drug tiers and/or removal of medications.
To ensure the best outcomes, we regularly review our formularies and make adjustments to promote the use of clinically appropriate and effective medications. Formulary updates may include drug additions, utilization management changes, changes to drug tiers and/or removal of medications.
A summary of changes effective July 1, 2025, is available for your review and includes the following:
- Zepbound GLP-1 Removal: The weight management GLP-1/GIP drug Zepbound will no longer be covered on F2, F3, F3 Choice, F2 CHART, and F4 CHART formularies. GLP-1 medications Wegovy and Saxenda will remain as alternative options.
- Stelara Biosimilars: We are adding coverage to formularies for two Stelara biosimilar products: Pyzchiva, (ustekinumab-TTWE) and Yesintek (ustekinumab-KFCE), to F1, F2, F3, F3 Choice, F2 CHART, F4 CHART, and EXCHANGE formularies. Stelara, Pyzchiva and Yesintek will all be preferred.
- Diabetes Test Supplies: OneTouch test strips and kits will be removed from F2, F3, F3 Choice, F2 CHART, and F4 CHART formularies. We are maintaining coverage for Accu Chek strips and kits on F2, F3, F3 Choice, F2 CHART, F4 CHART and EXCHANGE formularies and are adding coverage for True Metrix strips and kits.