Medicare AdvantageCoverageMedium impact
Coming soon: Formulary updates effective Jan. 1, 2025
UPMC Health Plan·Oncology, Hematology, Allergy & Immunology·Pharmacy
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
UPMC Health Plan is implementing formulary changes effective January 1, 2025, including moving certain IVIG/SCIG products from preferred to non-preferred status and requiring new prior authorizations for select IV oncology products. Members switching to preferred immune globulin products won't need updated authorizations.
Action Required
By January 1, 2025: Review UPMC formulary updates at provided links (upmchp.us/acformularychanges, upmchp.us/ycformularychanges, upmchp.us/PreferredImmuneGlobulins, upmchp.us/IVoncologyPA). Update prior authorization workflows for new IV oncology products requiring PA for new therapy starts. Verify current IVIG/SCIG product preferences before prescribing. Submit exception requests through SureScripts ePA or upmchp.us/ProviderPharmacyPAForms portal when needed.