CommercialCoverageMedium impact
21-323 Summary Update: Medication Trend Updates and Preferred Drug List Changes - 2nd Quarter 2021
Health Net·CA·Pharmacy
We identified it
Jun 20, 2026
Summary
Health Net updated their preferred drug lists for Q2 2021, requiring patients to try biosimilar medications before brand-name biologics will be approved. The policy also identifies upcoming patent expirations that will make generic alternatives available for common brand medications.
Action Required
Immediately: Update prior authorization workflows to require biosimilar step therapy for affected medications (Retacrit before Epogen/Procrit, Zarxio before Neupogen, etc.). Billing team should verify formulary status before prescribing and inform providers that brand biologics now require prior authorization and documentation of biosimilar failure or contraindications. Monitor upcoming generic availability for Q2-Q4 2021 medications to optimize formulary compliance.