CommercialCoverageMedium impact
Upcoming CareFirst Formulary Updates Effective July 1, 2025
CareFirst BlueCross BlueShield·Endocrinology, Family Medicine, Internal Medicine +3 more·Pharmacy
Effective date
Jul 1, 2025
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield will remove Zepbound (GLP-1 weight management drug) from coverage on most formularies effective July 1, 2025, while adding two Stelara biosimilars and removing OneTouch diabetes test strips. Alternative medications remain available for each category.
Action Required
By June 30, 2025: Clinical staff must identify patients currently prescribed Zepbound and coordinate with providers to transition to covered alternatives (Wegovy or Saxenda) before July 1. Update medication lists and prior authorization protocols for new Stelara biosimilars (Pyzchiva and Yesintek). Notify diabetic patients using OneTouch test strips to switch to Accu Chek or True Metrix products. Update formulary references in EMR and billing systems.