Preferred Product Program
To help keep health care affordable for our members, some medications have been identified as preferred products under our health plans. These preferred medications, including many biosimilars, offer the same safety, quality, and effectiveness as other available options while helping lower overall health care costs.
Many of the preferred products listed below are biosimilars. Biosimilars are medications derived from living organisms, such as plant or animal cells, bacteria, or yeast. They are rigorously reviewed and approved to meet the same standards for safety, purity, and effectiveness as their reference products.
| Drug Class | Preferred Product Changes outlined in orange. |
| Bevacizumab | 2026 Preferred Product: Mvasi & Zirabev 2027 Preferred Product: Mvasi, Zirabev, Vegzlema |
| Rituximab | 2026 Preferred Product: Ruxience, Truxima, Riabni 2027 Preferred Product: Ruxience, Truxima, Riabni |
| Infliximab | 2026 Preferred Product: Avsola, Inflectra 2027 Preferred Product: Avsola, Inflectra, Renflexis |
| Viscosupplements | 2026 Preferred Product: Durolane, Gelsyn-3, Supartz, Gel-One, Visco-3 2027 Preferred Product: Durolane, Gel-One Note: Gelsyn-3, Supartz, and Visco-3 are no longer preferred medications. |
| Denosumab | 2026 Preferred Product: Jubbonti, Stobclo 2027 Preferred Product: Jubbonti, Stobclo |
| Immune Globulins IV | 2026 Preferred Product: Octagam, Gemmaked, Gamunix-C, Gammargard, Privigen 2027 Preferred Product: Octagam, Gemmaked, Gamunix-C, Gammargard, Privigen |
| Immune Globulins SC | 2026 Preferred Product: Hyqvia, Hizentra, Xembify, Cutaquig 2027 Preferred Product: No preferred medication. Any medication in this category may be used for members. |
| Ustekinumab | 2026 Preferred Product: Selarsdi, Yesintek, Steqeyma 2027 Preferred Product: Selarsdi, Yesintek Note: Steqeyma is no longer a preferred medication. |
| Infused Iron | 2026 Preferred Product: Feraheme, Ferrlecit, INFed, Venofer 2027 Preferred Product: Feraheme, Ferrlecit, INFed, Venofer |
| Trastuzumab | 2027 Preferred Product: Kanjinti, Ogivri |
| Filgrastim | 2027 Preferred Product: Zivestym, Zerxio |
| Pegfilgastim | 2027 Preferred Product: Fulphila, Udenyca |
| Lupus | 2027 Preferred Product: Benlysta (IV), Saphnelo (SC) |
| Denosumab Biosimilars (Xgeva) | 2027 Preferred Product: Biloprevda, Xtrenbo |
| Denosumab Biosimilars (Prolia) | 2027 Preferred Product: Bildyos, Enoby |
| Injectable Asthma | 2027 Preferred Product: Nucala, Fasenra |
| Ocular VEGF | 2027 Preferred Product: Bevacizumab Please note that there is no prior authorization necessary for ocular VEGF. |
Prior Authorization
Many of the preferred medications above require prior authorization. To review prior authorization requirements or submit a request, go to Availity.com.
Effective Date of Preferred Products
We encourage providers to begin prescribing and administering preferred products reflecting the changes above for our members starting January 1, 2027. Enforcement of the preferred product program will go into effect with new medication prior authorizations and at the time of authorization renewal. If you would like assistance identifying members who may be affected by these changes, please reach out to our CarePath Team.
Exceptions
Member safety is our top priority. If you feel a member may need an exception due to a contraindication, please submit this documentation with your prior authorization. If you need assistance outside of the prior authorization process, please contact the CarePath medication team at 307-823-6095.
General Questions
The CarePath medication team is available to members and providers. If you’re currently taking one of these medications or prescribing these medications and have questions or concerns, please call 307-823-6095.
Provider Directory Validation Reminder
You can find the Provider Directory Validation guide under the Provider Resources section on the right rail of the website.
Providers can use the Directory Validation tool on the Availity Portal to find NPI and tax ID combinations.
No Surprises Act (NSA) requires you confirm this information every 90 days.