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Drug Policy Criteria Change

Arkansas Blue Cross Blue Shield·Pharmacy·Pharmacy
Effective date
Jul 1, 2026
We identified it
Jun 25, 2026
Days to comply
5 days

Summary

Tyruko (a retail drug) is transitioning from non-formulary to formulary coverage effective July 1, 2026. This means the drug will now be a covered benefit under formulary guidelines, potentially reducing patient out-of-pocket costs and changing claim adjudication requirements.

Action Required

Before Jul 1, 2026
By June 1, 2026: Billing and clinical teams must update formulary references and pharmacy benefit management (PBM) systems to reflect Tyruko as a formulary drug. Review patient records and claims for Tyruko prescriptions written before the effective date—these may still require non-formulary billing. Communicate the change to prescribers to ensure new prescriptions after 07/01/2026 reference the formulary status. Rebill any recent denied claims for Tyruko as non-formulary coverage transitions to formulary to recover potential reimbursement differences.