Medicaid Preferred Drug List and Formulary Changes
Date: July 23, 2026
Attention: Providers
Effective date: July 24, 2026
Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective July 24, 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 Texas Children Health Plan 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 | Preferred Alternative |
| ISOTRETINOIN (ORAL) CAPSULE (ABSORICA) [G] | ABSORICA (ORAL) CAPSULE [B] |
| MORPHINE SULFATE ORAL SOLUTION (ENFIT SYRINGE) [G] | MORPHINE SULFATE (ORAL) CONCENTRATED SOLUTION [G] |
| AMLODIPINE-VALSARTAN-HCTZ (ORAL) TABLET [G] | EXFORGE HCT (ORAL) TABLET [B] |
| ARBLI (ORAL) ORAL SUSP [B] | LOSARTAN POTASSIUM (ORAL) 25 MG [G] [D] |
| ENTRESTO (ORAL) TABLET [B] | SACUBITRIL-VALSARTAN (ORAL) TABLET [G] |
| TOVIAZ (ORAL) TAB ER [B] | FESOTERODINE FUMARATE ER (ORAL) TAB [G] |
| DUVYZAT (ORAL) SUSPENSION [B] | DEFLAZACORT (ORAL) TABLET [G] |
| AUSTEDO XR (ORAL) TAB [B] | TETRABENAZINE (ORAL) TABLET [G] [D] |
| INGREZZA SPRINKLE (ORAL) CAP [B] | TETRABENAZINE (ORAL) TABLET [D] |
| XENAZINE (ORAL) TABLET [G] | TETRABENAZINE (ORAL) TABLET [G] [D] |
| WINREVAIR (SUBCUT) KIT [B] | SILDENAFIL [G] [D], REVATIO [B] [D], AMBRISENTAN [G] [D] |
| LETAIRIS (ORAL) TABLET [B] | AMBRISENTAN (ORAL) TABLET [G] |
| RENVELA (ORAL) TABLET [B] | SEVELAMER CARBONATE (ORAL) TABLET [G] |
| ENOXAPARIN SODIUM (SUBCUT) (AG) SYRINGE [G] | LOVENOX (SUBCUT) SYRINGE [B] |
| ENOXAPARIN SODIUM (SUBCUT) (AG) VIAL [G] | LOVENOX (SUBCUT) SYRINGE [B] |
| PRADAXA (ORAL) CAPSULE [B] | DABIGATRAN ETEXILATE (ORAL) CAPSULE [G] |
| ESCITALOPRAM OXALATE (ORAL) CAPSULE [G] | LEXAPRO (ORAL) TABLET [B] |
| PREVYMIS (ORAL) PELET PACK [B] | VALGANCICLOVIR SOLN 50MG/ML [G] [D] |
| PREVYMIS (ORAL) TABLET [B] | VALGANCICLOVIR TABLET 450MG [G] [D] |
| BUCAPSOL (ORAL) CAPSULE [B] | BUSPIRONE (ORAL) TABLET [G] |
| LIVMARLI (ORAL) SOLUTION 19 MG/ML [B] | URSODIOL (ORAL) CAPSULE [G] [D] |
| OTEZLA XR (ORAL) TAB ER 24H [B] | SKYRIZI (INJECTION) [B] [D], TREMFYA (INJECTION) [B] [D] |
| EKTERLY (ORAL) TABLET [B] | ORLADEYO (ORAL) CAPSULE [B] [D] |
| GAMMAGARD LIQUID ERC (INJECTION) VIAL [B] | PRIVIGEN (INTRAVEN) VIAL [B] [D] |
| ZORYVE (TOPICAL) CREAM 0.05% [B] | EUCRISA (TOPICAL) OINTMENT 2% [B] [D] |
*In addition to PDL, these medications also have a clinical prior authorization requirement.
^This is a suggested alternative. Please discuss these options with your provider to determine therapy.
[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.
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 preferred drug list (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 step 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