November 20, 2025
Thank you for your continuing efforts to improve the health outcomes of our members. This letter is to inform you of the changes to the Statewide Preferred Drug List for the 2026 benefit year for members enrolled with Health Partners Plans Medicaid.
Below is a list of the top formulary disruptions due to this change along with their updated preferred alternative(s). These changes will go into effect on January 5, 2026. Please note, this is not an all-inclusive listing.
Therapeutic Class |
Non-Preferred Drug |
Preferred Alternative(s) |
Angiotensin Modulators |
Entresto Tablet | Sacubitril-Valsartan Tablet |
Anticoagulants |
Pradaxa Capsule |
Dabigatran |
Antiemetics-antivertigo agents |
Diclegis Tablet |
Doxylamine Succinate-Pyridoxine DR Tablet |
Meclizine 50 mg Tablet |
Meclizine 12.5 mg, 25 mg Tablet |
|
Cytokine and CAM antagonists |
Adalimumab HIGH Concentration Products: Adalimumab-adaz, Adalimumab-adbm (BI labeler), Amjevita, Hadlima, Humira |
Adalimumab-aaty(CF) 100 mg/mL Simlandi(CF) 100 mg/mL |
Adalimumab LOW Concentration Products: Adalimumab-aacf, Adalimumab-adbm (BI labeler), Humira, Yusimry |
Adalimumab-fkjp(CF) 50 mg/mL Hadlima 50 mg/mL |
|
Otulfi, Selarsdi, Steqeyma, Yesintek |
Pyzchiva |
|
Hypoglycemics |
Invokana, Invokamet | Farxiga, Jardiance, Synjardy XR, Xigduo XR |
The changes listed below will go into effect on January 1, 2026.
Therapeutic Class |
Preferred Drugs |
Effective January 1, 2026 |
Hypoglycemics, DPP-4 inhibitors |
Janumet, Janumet XR, Januvia, Jentadueto, Jentadueto XR, Tradjenta |
All preferred DPP-4 inhibitors will require prior authorization |
For the most up-to-date information regarding Health Partners Plans formularies, please visit our online formulary at hpplans.com/formulary.
The complete 2026 Statewide Preferred Drug List and prior authorization clinical guidelines will be posted prior to January 1, 2026, at papdl.com
For more information, call our Pharmacy department at 215-991-4300 or our Provider Services Helpline at 1-888-991-9023 (Monday to Friday, 9 am to 5:30 pm).
Thank you for your continued partnership in supporting your patients and our members.