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2026 Q2 Drug Formulary Change Notification

  • 03/02/2026

Hennepin Health is making a change to its drug formulary for Q2 2026. This change applies to Hennepin Health-PMAP, Hennepin Health-MNCare and Hennepin Health-SNBC members. Changes are effective either May 1, 2026, or May 7, 2026. Members who are directly impacted will receive notification of the changes. The updated full drug formulary is available on the Hennepin Health website. A printed copy can be obtained by calling Provider Services at 612-596-1036 (select option 2).  

Effective May 1, 2026, these medications will be added as preferred drugs to the formulary: 

  • Ticagrelor 
  •  Adalimumab-adbm syringe 
  • Adalimumab-adbm pen 
  • Cyltezo syringe 
  • Cyltezo pen 
  • Pyzchiva vial (subcutane.) 
  • Pyzchiva syringe (subcutane.) 
  • Pyzchiva vial (intravenous) 
  • Steqeyma syringe (subcutane.) 
  • Steqeyma vial (intravenous) 
  • Yesintek syringe (subcutane.) 
  • Yesintek vial (subcutane.) 
  • Ramelteon 
  • Clonidine ER (Drug Class category: Stimulants and Related Agents) 
  • Methylphenidate ER (Ritalin LA) 

Effective May 1, 2026, these medications will be removed as preferred drugs on the formulary and will require a prior authorization: 

  • Mononine kit 
  • Epivir HBV solution 
  • Epivir HBV tablets 
  • Hepsera 
  • Pegasys Proclick 
  • Pancreaze 
  • Aciphex tablets 
  • Zegerid 
  • Apriso (oral) 
  • Colazal (oral) 
  • Uceris (oral) 
  • Uceris (rectal) 
  • BP 10-1 (topical) 
  • Ovace Plus Cream ER (topical)
  • Ovace Plus Shampoo (topical) 
  • Fycompa tablet dose pack 
  • Mysoline 
  • Vimpat tablet dose pack 
  • Fortical (nasal) 
  • Liqrev suspension 
  • Oxbryta 
  • Ritalin LA 
  • Adhansia XR 

Effective May 1, 2026, these medications will require a prior authorization, and a quantity limit (QL) will be indicated if applicable:

  • Renvela tablet
  • Brilinta, QL = 2 tabs/day
  • Eslicarbazepine
  • Perampanel tablet
  • Bildyos
  • Bilprevda
  • Bomyntra 
  • Bonsity
  • Conexxence 
  • Jubbonti 
  • Osenvelt 
  • Stoboclo 
  • Wyost 
  • Xgeva 
  • Humira Kit, QL = 2 syringes/28 days
  • Humira Pen Kit, QL = 2 syringes/28 days
  • Adalimumab-adbm syringe (quallent)
  • adalimumab-adbm pen (quallent)
  • Avtozma
  • Imuldosa syringe (subcutane.) 
  • Imuldosa vial (IV) 
  • Otezla XR 
  • Otulfi syringe (subcutane.)
  • Otulfi vial (IV) 
  • Selarsdi syringe (subcutane.)
  • Selarsdi vial (IV)
  • Ustekinumab syringe (subcutane.)
  • Ustekinumab vial (IV) 
  • Ustekinumab vial (subcutane.)
  • Ustekinumab-aekn syringe (subcutane.)
  • Ustekinumab-ttwe vial (quallent MFG)(IV)
  • Ustekinumab-ttwe syringe (quallent MFG) (subcutane.) 
  • Andembry 
  • Dawnzera
  • Ekterly
  • Brynovin
  • Zituvimet
  • Zituvimet XR
  • Yutrepia
  • Rozerem, QL = 1 tab/day
  • Doxepin tablet
  • Xromi solution
  • Amphetamine ER ODT
  • Onyda XR suspension

Effective May 1, 2026, this medication has a change in the quantity limit:

  • Methylphenidate tab (RITALIN equiv), the QL is changing from QL = 6 tabs/day to QL = 2 tabs/day

Effective May 1, 2026, these medications are discontinued products and are removed from the formulary:

  • Norvir Cap (GPI-12, Drug ID: 121045600001)
  • Abacavir/lamivudine/zidovudine tab (GPI-12, Drug ID: 121099032003)
  • Melphalan Tab (GPI-12, Drug ID: 211010400003)
  • Intron-A Inj (GPI-12, Drug ID: 217000602020; 217000602021)
  • Contraceptive Foam (GPI-12, Drug ID: 553000100039)
  • Nonoxynol-9 Foam 12.5% (GPI-12, Drug ID: 55300010003920
  • Enbrel Inj 25 mg (GPI-12, Drug ID: 662900300021)
Effective May 7, 2026, these medications will be added as preferred drugs to the formulary and will have quantity limit requirements:
  • Carvedilol ER cap, QL = 1 cap/day, only one strength allowed per month
  • Carbatrol Cap 100 mg, 200 mg, QL = 2 caps/day, only one strength allowed per month
  • Carbatrol Cap 300 mg, QL = 4 caps/day, only one strength allowed per month
  • Sacubitril-valsartan, QL = 2 tabs/day 

Effective May 7, 2026, these medications will require a prior authorization, and a quantity limit (QL) will be indicated if applicable:

  • Coreg CR, QL = 1 cap/day, only one strength allowed per month
  • Entresto
     

Resources

  • List of covered drugs (Formulary) effective 5/1/26 (PDF, 3MB)
  • List of covered drugs for SNBC members with Medicare coverage (Formulary) effective 5/1/26 (PDF, 3MB)
  • Hennepin Health Customer Services: 612-596-1036 (press 2)
  • Hennepin Health website: www.hennepinhealth.org
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