MedicaidCoverageMedium impact
NC Medicaid Off-Cycle Change to the Preferred Drug List Due to Lantus SoloStar Pen Shortage
NC Medicaid - NCDHHS·NC · Endocrinology, Internal Medicine, Family Medicine +2 more·Pharmacy
Effective date
Jul 24, 2026
We identified it
Aug 11, 2026
Summary
NC Medicaid has moved Basaglar® U-100 KwikPen® from Non-Preferred to Preferred status on the Preferred Drug List (PDL) effective July 24, 2026, due to a Lantus SoloStar pen shortage. Lantus SoloStar pen remains co-preferred. This change applies to both NC Medicaid Direct and NC Medicaid Managed Care plans to ensure continued beneficiary access to long-acting insulin.
Action Required
By July 24, 2026: Billing and pharmacy teams must update their system formularies and prior authorization rules to reflect Basaglar® U-100 KwikPen® (HCPCS J7364/J7365) as Preferred status for NC Medicaid Direct and all NC Medicaid Managed Care plans (AmeriHealth, Healthy Blue, Carolina Complete, UnitedHealthcare, Alliance Health, Partners, Trillium, Vaya Health, and Healthy Blue Care Together). Update claims processing rules to process Basaglar claims without prior authorization when medically appropriate. Notify prescribers that Basaglar is now preferred, reducing patient cost-sharing. No prior authorization should be denied for either Basaglar or Lantus SoloStar during the shortage period. Verify formulary changes in billing software before the effective date to prevent claim denials or delays.