October 2025 UPMC for You and UPMC Community HealthChoices formulary update

Oct. 2025Pharmacy Updates

Effective Oct. 1, 2025, Xifaxan and Retin-A (cream, gel) will no longer be covered by UPMC for You and UPMC Community HealthChoices due to nonparticipation in the Medicaid Drug Rebate Program.

There are covered alternatives that may be an option for your patients, depending on their health needs.

Tretinoin cream is a covered alternative for Retin-A (cream, gel).

Covered alternatives for Xifaxan include loperamide capsule, dicyclomine (10 mg capsule, 20 mg tablet), lactulose solution, and azithromycin. Coverage is available for Xifaxan 200 mg tablet for a diagnosis of hepatic encephalopathy only and a prior authorization is required. The dose and duration of therapy for Xifaxan 200 mg tablet must be consistent with nationally recognized compendia or peer-reviewed literature.

Xifaxan coverage update

Coverage of Xifaxan tablet, including both the 200 mg and 550 mg strengths, is no longer available under UPMC for You and UPMC Community HealthChoices.

The manufacturer of Xifaxan may provide the drug to Medicaid patients at no cost through its patient assistance program. The program application is available by phone at 1-833-862-8727 or online at bauschhealthpap.com.

Recent Announcements

Asymptomatic Severe Coronary Disease: Detection to Decisions. Do We Know The Proper Management?

In this new CME course, Krishna V. Tummalapalli, MD, interventional cardiologist, UPMC Heart and Vascular Institute, discusses how to explain the importance of early detection of coronary artery disease, as well as how to describe how early identification can reduce future cardiovascular events and identify appropriate first line medical therapy strategies for patients with asymptomatic stable ischemic heart disease.
Mar. 2026Education/Webinars

2026 Preventive Care Rewards Program

Preventive Care Rewards Program
Mar. 2026Important Notices

CME Webinar Series: Introducing Physicians and their teams to Value-Based Health Care

Please join us for a new CME-accredited webinar series on value-based care. This series is designed to introduce practicing physicians and their teams to value-based health care. Over the course of six sessions, we will define the components of value and identify the tools necessary to deliver high-value care for a population.
Feb. 2026Education/Webinars