Medicaid Preferred Drug List and Formulary Changes

Date: January 23, 2026

Attention: All Providers

Effective Date: January 30, 2026

Call to action: Texas Children’s Health Plan (TCHP) is notifying providers that effective January 30, 2026, select medication(s) moved from “preferred” to “non-preferred” status. A summary of the changes is included below.

Resource:https://www.txvendordrug.com/formulary/preferred-drugs

Changes with biggest impact to TCHP members and providers: The drugs listed below were either not previously reviewed (NR) and became non-preferred (NPD) or previously considered a preferred agent (PDL) but now have changed status to non-preferred.

Impacted Medication	Status Change	Type	Preferred Alternative
ANUSOL-HC (TOPICAL) CRM/PE APP [B]	PDL→ NPD	STEROIDS, TOPICAL	HYDROCORTIONSE RECTAL (TOPICAL) CREAM[G]
ATTRUBY (0FLAL) TABLET (ORAL) [B]	NR→ NPD	TRANSTHYRETIN-RMATED AMYLOIDOSIS	VYNDAMAX (OFLAL) (ORAL) CAPSULE [B] [D]*
BONSITY (SUBCUTAENOUS) PEN INJECTORR [B]	NR→ NPD	BONE RESORPTION SUPPRESSION AND RELATED AGENTS	FORTEO (SUBCUTAENOUS) PEN INJECTOR [B]
ERYPED 400 (ORAL) SUSPENSION	PDL→ NPD	MACROLIDES-KETOLIDES	ERYTHROMYCIN SUSP 200/5M (ORAL)[G]
ERYTHROMYCIN (ORAL) CAPSULE DR BASE [B]	PDL→ NPD	MACROLIDES-KETOLIDES	ERYTHROMYCIN (ORAL) TABLET [G]
EVISTA (ORAL) TABLET [B]	PDL→ NPD	BONE RESORPTION SUPPRESSION AND RELATED AGENTS	RALOXIFENE (ORAL) TABLET [G]
GRANIX (SUBCUTANEOUS) VIAL [B]	PDL→ NPD	COLONY STIMULATING FACTORS	GRANIX (SUBCUTANEOUS) PREFILLED SYRINGE [B]
KATERZIA (ORAL) SUSPENSION [B]	PDL→ NPD	CALCIUM CHANNEL BLOCKERS (ORAL)	NORLIQVA (ORAL) SUSPENSION [B]
MEMANTINE HCL-DONEPEZIL HCL ER (ORAL) CAP SPR 24 [B]	NR→ NPD	ALZHEIMERS AGENTS	MEMATNINE 28 MG ER CAPSULE (ORAL) [G] AND DONEPEZIL 10 MG TABLET (ORAL) [G]
METFORMIN HCL (ORAL) TABLET 750 MG [G]	NR→ NPD	HYPOGLYCEMICS, METFORMIN	METFORMIN HCL (ORAL) TABLET 500 MG [G], METFORMIN HCL (ORAL) TABLET 850 MG [G], METFORMIN HCL (ORAL) TABLET 1000 MG [G]
METRONIDAZOLE (ORAL) TABLET 125 MG [G]	NR→ NPD	ANTIBIOTICS, GASTROINTESTINAL	METRONIDAZOLE (ORAL) TABLET 250 MG [G]
METRONIDAZOLE (TOPICAL) GEL W/PUMP [G]	PDL→ NPD	ROSACEA AGENTS, TOPICAL	METRONIDAZOLE (TOPICAL) GEL [G]*
NATROBA (TOPICAL) SUSPENSION [B]	NR→ NPD	ANTIPARASITICS, TOPICAL	SPINOSAD SUSPENSION 0.9% (TOPICAL) [B]
NEUPOGEN (INJECTION) SYRINGE [B]	PDL→ NPD	COLONY STIMULATING FACTORS	GRANIX (SUBCUTANEOUS) PREFILLED SYRINGE [B] [D], NIVESTYM (SUBCUTANEOUS) INJECTION [B] [D]
NEUPOGEN (INJECTION) VIAL[B]	PDL→ NPD	COLONY STIMULATING FACTORS	GRANIX (SUBCUTANEOUS) PREFILLED SYRINGE [B] [D], NIVESTYM (SUBCUTANEOUS) INJECTION [B] [D],
ONAPGO (SUBCUTANEOUS) CARTRIDGE [B]	NR→ NPD	ANTIPARKINSONS AGENTS	ROPINIROLE (ORAL) TABLET [G] [D], PRAMIPEXOLE (ORAL) TABLET [G] [D]
POSACONAZOLE (ORAL) SUSPENSION [G]	PDL→ NPD	ANTIFUNGALS, ORAL	NOXAFIL (ORAL) SUSPENSION [B]
POSACONAZOLE (ORAL) TABLET [G]	PDL→ NPD	ANTIFUNGALS, ORAL	NOXAFIL (ORAL) TABLET [B]
SCOPOLAMINE (TRANSDERMAL) PATCH [G]	NR→ NPD	ANTIEMET1C-ANTIVERT1G0 AGENTS (EXCLUDES INJECTABLES)	TRANSDERM-SCOP (TRANSDERMAL) PATCH[B]
SITAGLIPTIN-METFORMIN ER (ORAL)TBMP 24HR (AG) [G]	NR→ NPD	HYPOGLYCEMICS, INCRET1N MIMETICS-ENHANCERS	JANUMET (ORAL) TABLET [B]*
TEZRULY (ORAL) SOLUTION [B]	NR→ NPD	BPH TREATMENTS	TERAZOSIN (ORAL) TABLET [G] [D]
TRYNGOLZA (SUBCUTANEOUS) AUTO INJECTOR	NR→ NPD	LIPOTROPICS, OTHER	FENOFIBRATE (ORAL) TABLET, CAPSULE [G] [D]*
VYNDAQEL (0FLAL) CAPSULE (ORAL) [B]	NR→ NPD	TRANSTHYRETIN-RMATED AMYLOIDOSIS	VYNDAMAX (OFLAL) (ORAL) CAPSULE [B] [D]*
WAINUA (SUBCUTANEOUS) AUTO I NJECTOR [B]	NR→ NPD	TRANSTHYRETIN-RMATED AMYLOIDOSIS	VYNDAMAX (OFLAL) (ORAL) CAPSULE [B] [D]*
ZELSUVMI (TOPICAL) GEL [B]	NR→ NPD	ANTIVIRALS, TOPICAL	ACYCLOVIR (TOPICAL) CREAM [G][D]
ZUNVEYL (ORAL) TABLET [B]	NR→ NPD	ALZHEIMERS AGENTS	DONEPEZIL (ORAL) TABLET [G]

*In addition to PDL, these medications also have a clinical prior authorization requirement.

[B] Signals the medication is brand.

[G] Signals the medication is generic.

[D] No direct alternative agent and/or comparable agent as a suitable recommendation, defer to physician’s decision

NR stands for Not Reviewed

PDL stands for Preferred Drug List

NPD stands for Non-Preferred Drug

How this impacts providers: Preferred and non-preferred medications may continue to require clinical prior authorizations. In addition to any clinical prior authorization requirements, non-preferred medications will also require a “step therapy prior authorization.” Non-preferred drugs on the formulary require prior approval and are only approved when there is clinical justification as to why the patient cannot use the preferred drug, including failure/side effects or contraindications to the preferred agents.

This means that members must have attempted and failed at least one preferred medication before obtaining a non-preferred medication.

The PDL can be found on the VDP website https://www.txvendordrug.com/formulary/preferred-drugs. Medicaid managed care plans are required to follow the PDL.

Next steps for providers: Preferred drugs are medications recommended by the Texas Drug Utilization Review Board for their efficaciousness, clinical significance, cost effectiveness, and safety. Texas Children’s Health Plan encourages providers to initiate a preferred medication to members new to therapy. When possible, Texas Children’s Health Plan also encourages switching existing members to a preferred agent.

If you have any questions, please email TCHP Pharmacy Department at: TCHPPharmacy@texaschildrens.org.

For access to all provider alerts: www.texaschildrenshealthplan.org/provideralerts.