​​​​​​​Independence Blue Cross (IBX) and Independence Administrators will update the Premium Formulary drug program effective July 1, 2026.

The Premium Formulary, available to self-funded customers, includes drugs across all therapeutic categories selected for clinical effectiveness, safety, and savings. It is managed by an independent pharmacy benefit manager (PBM) and reviewed twice a year to add new drugs and remove brand-name drugs when generics become available.

Key updates to the Premium Formulary

• Animal-derived thyroid medications (i.e., NP Thyroid®, Armour® Thyroid): Animal-derived thyroid medications will be excluded due to the Food and Drug Administration (FDA) concerns about inconsistent dosing and potential impurities. The FDA is encouraging a transition to approved synthetic treatments for hypothyroidism. Preferred formulary alternatives include levothyroxine and liothyronine, which are covered on the generic tier.
• Hormonal agent, Premarin® (conjugated estrogens): Premarin will move to an Excluded status, with generic conjugated estrogen tablets being the preferred formulary alternative; they are available on the generic tier.
• Revlimid® (lenalidomide): Brand Revlimid remains Tier 2 and generic lenalidomide remains Tier 1. Effective July 1, a brand dispensed as written (DAW) penalty will apply for clients that have elected it, as generic supply has stabilized. Members using brand Revlimid will be notified that their cost-share may increase if they do not switch to the generic.
• Dermatological Agents, Twyneo® (tretinoin/benzoyl peroxide) cream: Twyneo will move to an Excluded status, with the preferred formulary alternatives being Epiduo® Forte, Onexton®, and Retin-A Micro® gel 0.06%, 0.08%.
• Dermatological Agents, Sodium Sulfacetamide/Sulfur liquid 10-5%: Sodium Sulfacetamide/Sulfur liquid will move to an Excluded status, with the preferred formulary alternatives being any preferred acne medication.

​Key updates to Utilization Management

Utilization Management updates include step therapy protocol for topical immunomodulators as well as new quantity limits for ivermectin.  

• Topical Immunomodulators, Zoryve® (roflumilast) foam 0.3%: The Step Therapy protocol will now require trial through at least one topical steroid cream or any of the following: Pramoxine-HC, calcipotriene-betamethasone, tacrolimus, pi​​mecrolimus, calcipotrine, calcitrol, tazarotene, clotrimazole, econazole, ketoconazole, luliconazole, miconazole, oxiconazole, sertaconazole, sulconazole, or selenium sulfide.
• New quantity limits will go into effect for ivermectin 6mg to better define coverage for an amount sufficient for treatment, as defined in product labeling.​​
  

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