- ffective October 10, 2017, Lantus (insulin glargine) will no longer be a covered medication on the Medicaid formulary.
- Effective October 10th, Basaglar (insulin glargine) KwikPen will be the ONLY insulin glargine covered on the Medicaid formulary.
|
Formulary |
Non-Formulary |
|
Basaglar KwikPen* |
Lantus vials Lantus SoloStar |
*Covered on Formulary with a Quantity Limit 30 mL. Prior Authorization is required for quantities greater than 30ml per Rx.
The Neighborhood Medicaid Formulary applies to members under the following plans: ACCESS and TRUST.
Below is a summary comparison of Basaglar formulary status across all Neighborhood formularies:
| Formulary | Formulary Status as of 10-10-2017 | Note(s) |
| Medicaid | Formulary | Quantity Limit = 30ml per 30 days (PA required for >30ml) |
| Exchange | Formulary, Tier 2/Preferred Brand | Quantity Limit = 30ml per 30 days (PA required for >30ml) |
| INTEGRITY | Non-Formulary | Formulary as of January 1st, 2018 |
The Neighborhood Formulary for these plans can be found on the Pharmacy Resources page.