Coming soon: Formulary updates effective Jan. 1, 2025

Jan. 2025Important Notices

Please review updated information for the prescription drugs covered under each plan.

UPMC Health Plan Commercial plans

UPMC for Life Medicare and SNP plans

View UPMC for Life formulary updates:

IVIG/SCIG preferred products
Effective Jan. 1, 2025, certain intravenous immune globulin (IVIG) and subcutaneous immune globulin (SCIG) products that are preferred in 2024 will move to nonpreferred for all UPMC lines of business. All products currently require prior authorization in 2024, which will continue in 2025 regardless of status. However, members currently on nonpreferred products will not need updated authorizations when switching to preferred products in 2025. Please reference upmchp.us/PreferredImmuneGlobulins for preferred and nonpreferred products.

IV oncology prior authorization
Effective Jan. 1, 2025, select medically administered oncology products will require a prior authorization for all UPMC lines of business and drug formularies. The prior authorization applies only to new starts to therapy. The criteria for approval include that the requested drug is used for a medically accepted indication, prescribed by or in consultation with a specialist, and used for a dose and duration consistent with FDA-approved labeling or clinical literature. Please refer to products that will newly require prior authorization as of Jan. 1, 2025: upmchp.us/IVoncologyPA

Exception request options
Requests for exceptions can be submitted to Pharmacy Services by one of the following methods:

Recent Announcements

Clinical workflow changes through Epic®

Changes are coming for network providers that utilize Provider OnLine to submit specific information to UPMC Health Plan. Select activities that were previously completed in Provider OnLine will now transition to UPMC Health Plan Tapestry Link.
Sep. 2026Important Notices

CME Webinar: Lifestyle Medicine in Practice: Evidence‑Based Strategies for Chronic Disease Care

Please join us for a live, CME-accredited webinar on Wednesday, Sept. 23 from noon to 1 p.m., that will provide an overview on lifestyle medicine. Participants will learn how to integrate six core domains—nutrition, physical activity, sleep, stress management, avoidance of risky substances, and social connection—into routine care using practical tools such as brief counseling, motivational interviewing, and team-based strategies.
Sep. 2026Education/Webinars

Voluntary nationwide recall: Sodium Chloride (B. Braun – August 2026)

B. Braun Medical Inc. is recalling three lots (lots J6B435, J6B444 and J6B457) of 0.9% Sodium Chloride Injection USP, 100 mL. Sodium Chloride is used as a source of electrolytes and water.
Sep. 2026Pharmacy Updates