BT2026184

Indiana Health Coverage Programs (IHCP) Bulletin BT2026184, issued October 29, 2026, announces pharmacy coverage updates approved by the Indiana Drug Utilization Review (DUR) Board at its October 16, 2026 meeting. All changes take effect for prior authorization (PA) requests submitted on or after January 1, 2027, and for fee-for-service (FFS) and managed care claims with dates of service on or after January 1, 2027. The bulletin updates the automated Point of Sale Quick Check (PSQC) PA system criteria for ten drug categories, including Antipsychotic Therapy, Opioid Overutilization, Sedative Hypnotics/Benzodiazepines, Stimulants Therapy, and SSRIs/SNRIs Duplicate Therapy, among others. New PA criteria are established for eight additional categories: Bone Resorption Inhibitors, Dronabinol, GLP-1 Receptor Agonists and Combinations, Growth Hormones, Menopausal Symptom Suppressants, Non-SUPDL Agents, PCSK9 Inhibitors and Select Lipotropics, and Spravato (esketamine). The Non-SUPDL Agents PA and step therapy criteria apply exclusively to the FFS benefit. The Statewide Uniform Preferred Drug List (SUPDL) changes span more than 20 drug classes. Notable changes include: Spravato (esketamine) elevated to preferred status under Mental Health Antidepressant Agents; Rezenopy (naloxone) added as nonpreferred to the Opioid Overdose subcategory; Zimhi (naloxone) removed from the SUPDL; Fiasp (insulin aspart) moved to nonpreferred with continuation allowed for current utilizers; Toujeo/Toujeo Max (insulin glargine) elevated to preferred; lisdexamfetamine chewable elevated to preferred; Vyvanse (lisdexamfetamine) chewable downgraded to nonpreferred; Relexxii ER (methylphenidate) elevated to preferred; and Relgaabi (gabapentin) downgraded to nonpreferred. Extensive preferred/nonpreferred subcategory assignments are made across the Blood Factor Agents class, covering Factor VIII, Factor IX, Factor VII, Factor X, Factor XIII, von Willebrand Factor, fibrinogen, and prothrombin complex concentrate products. The Preferred Brand Drug List adds Absorica (isotretinoin) and Adempas (riociguat) and removes Vfend (voriconazole) suspension and Vyvanse (lisdexamfetamine) chewable. The Preferred HIV Agents List adds eight antiretroviral regimens, including Delstrigo, Genvoya, Isentress, Isentress HD, Pifeltro, Prezcobix, Stribild, and Symtuza, all effective for FFS and managed care claims with dates of service on or after January 1, 2027.