Pharmacy Information and Preferred Drug List Changes - Second Quarter 2025
Date: 04/29/25
Trillium Community Health Plan Preferred Long-Acting Insulin Coverage
Trillium’s Preferred long-acting insulin is insulin glargine-yfgn. In February the manufacturer of insulin glargine-yfgn announced that they were anticipating a shortage of the branded and unbranded pens which they expected to be resolved the first week of March. In response to this announcement Trillium entered overrides for Latus for members currently utilizing insulin glargine-yfgn through March 31, 2025. Unfortunately, the impact of the insulin glargine-yfgn shortage is ongoing and many pharmacies within our service area continue to have difficulty obtaining insulin glargine-yfgn.
As of April 21st, Lantus (insulin glargine) vials and SoloStar pens have been added to Trillium’s Preferred Drug List temporarily to address the continued shortage of insulin glargine-yfgn. Lantus and insulin glargine-yfgn are interchangeable and thus members do not require a new prescription for pharmacies to dispense. Please continue to prescribe insulin glargine-yfgn to help promote utilization of the lowest cost agent when available. Any pharmacy unable to obtain insulin glargine-yfgn should be instructed to run the claim for Lantus.
Trillium Community Health Plan Preferred Drug List Changes
Trillium’s Preferred Drug List (PDL) is updated monthly and is available online. View this notice (PDF) for a summary of the PDL changes made in the second quarter of 2025. For the most current preferred drug list, visit the Pharmacy section of our website.
Prior Authorization Changes to Specialized Medications Given in Office
View this notice (PDF) for the list of new HCPC codes. These codes now require prior authorization for coverage for Trillium Oregon Health Plan members.
Quarterly Update on Pharmacy Coverage Guidelines
The P&T Committee determines updates to coverage guidelines (criteria) based on quarterly, comprehensive reviews. Criteria serves as a reference for providers to use when prescribing pharmaceutical products for Trillium members with pharmacy coverage. Prior authorization (PA) does not guarantee payment. PA determination is based on multiple factors in conjunction to the criteria posted in drug coverage guidelines. These factors include but are not limited to: treatment of a funded vs non-funded condition as defined by the Oregon Prioritized List and applicable guidelines; prior trial and failure of agents on the PDL; comparative costs of available treatment options.
View this notice (PDF) for all the updated or new Trillium Community Health Plan coverage guidelines that were approved by P&T in the second quarter of 2025. All coverage guidelines will go into effect July 1, 2025 and will become available to view in their entirety at our website approximately 2 weeks prior to their implementation date.
Additional Information
For additional information regarding changes to the Trillium Preferred Drug List (PDL), contact Trillium by telephone at 1-877-600-5472. For the most current version of the PDL, visit the Pharmacy section of the Trillium website.
For additional information on medication coverage guidelines, visit the Provider Resources section of Trillium’s website.
If you have questions regarding the information contained in this update, contact Trillium Provider Services through the Provider Resources section of the Trillium website or by telephone at 1-877-600-5472.