Pharmacy Passages
Pharmacy Passages is an Optum Rx publication listing monthly updates to our standard formularies. For updates specific to health plans and custom drug lists, please check with the member's prescription benefit plan.
Formulary & UM updates
These updates may include exclusions, tier changes, prior authorizations, quantity limits and/or step therapy.
January 1, 2025 updates
Prior authorization
Step therapy
Quantity limits
July 1, 2024 updates
Prior authorization
Step therapy
Quantity limits
Supporting your patients
During formulary cycle updates, Optum Rx reaches out to impacted patients with the information they need, including suggested covered alternative medications. We’re here to support you and your patients through this process.
Here are a few things you can do to help make the transition smoother for your patients:
- Reach out to your patient
Or they may be contacting you with questions. - Discuss their options
Determine if other covered medications could benefit the patient. - Select the medication
If alternative medication is selected, send us an e-prescription. (Send CancelRx for the affected medication.) - Sticking with their current medication?
A prior authorization may be required. Visit go.covermymeds.com/optumrx to submit.
Certain states require Optum Rx to communicate prior authorization changes before the effective date. Flyers are sent to members to outline the drugs affected by prior authorization, quantity limits, and step therapy based on benefit plan designs. Please review each document for more details.
Please note: these changes may not reflect final P&T Committee determinations. These changes are specific to prescription drug benefits only, and do not reflect changes that may occur at the health plan level. Prescribers are strongly encouraged to check with the health plan for other changes that may occur.