CommercialCoverageMedium impact
Pharmacy Program Quarterly Update Changes Effective July 1, 2025 – Part 2
BCBS Texas·TX · Pharmacy·Pharmacy
Effective date
Jul 1, 2025
We identified it
Jan 12, 2026
Summary
Blue Cross Blue Shield of Texas is adding 23 new medications to their pharmacy formularies effective July 1, 2025, across multiple drug lists (Balanced, Performance, Performance Select, Basic, Enhanced tiers). Additionally, the Corticotropin Prior Authorization program is being updated to remove Acthar Autoinjector, and the Vitamin B12 Deficiency PAQL program was retired June 15, 2025. These are pharmacy coverage additions that do not require member notification.
Action Required
By July 1, 2025: Billing and pharmacy staff must update internal formulary databases and prior authorization systems to reflect new drug coverage additions across all BCBSTX drug lists. Remove Acthar Autoinjector from Corticotropin PA requirements for all plan tiers (Basic, Basic Multi-Tier, Enhanced, Enhanced Multi-Tier, Basic Annual, Basic Multi-Tier Annual, Enhanced Annual, Enhanced Multi-Tier Annual, HIM, Balanced, Performance, Performance Annual, and Performance Select). Confirm that Nascobal (cyanocobalamin nasal spray) no longer requires prior authorization per the June 15, 2025 retirement of the Vitamin B12 Deficiency PAQL program. Update billing software and prior authorization workflows to recognize the new medications (ATTRUBY, EMROSI, HYDROCORTISONE, HYMPAVZI, ITOVEBI, LIVDELZI, MIPLYFFA, REVUFORJ, SELARSDI, STEQEYMA, TRYVIO, WAKIX, YESINTEK, AQNEURSA, VYALEV, and YORVIPATH) as covered. Failure to update systems may result in claim denials for newly covered drugs or unnecessary PA requirements for Acthar Autoinjector.