Member Important Updates on NYRx, the Medicaid Pharmacy Benefit

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Subject: Important Updates on NYRx, the Medicaid Pharmacy Benefit
Dear Members,

We hope this communication finds you well. We have news about NYRx. Your health matters to us, and we want to give you the latest information to help you manage your drugs and supplies.

What is NYRx?
NYRx is your New York Medicaid pharmacy benefit. NYRx covers your prescription drugs and supplies, and some over-the-counter items. To see what's covered under the NYRx program, visit https://member.emedny.org/.
Key Updates
Coverage Stopped for Some Drug Manufacturers:

Starting April 1, 2026, the drugs made by the companies below will no longer be covered by NYRx:
  • Aralez Pharmaceuticals, INC
  • Pilnova Pharma
  • Leadiant Biosciences
  • Global Blood Therapeutics, INC
  • STI Pharma, LLC
  • GlaxoSmithKline LLC
  • Avalo Therapeutics INC
  • Invernis Pharmaceuticals, INC
Other companies that make the same generic drugs are still covered by NYRx. Your pharmacy may switch to a different company's version of the drug and will let you know if this happens. The following drugs may be impacted:
  • Toprol XL 25 MG Tablet
  • Toprol XL 50 MG Tablet
  • Toprol XL 100 MG Tablet
  • Toprol XL 200 MG Tablet
  • Azacitidine 100 MG Vial
  • Abelcet 100 MG/20 ML Vial*
How will you get these drugs?
You will still be able to get these drugs, but your pharmacy may change what drug manufacturer the drug comes from. If you are taking one of the drugs above and are unsure if you will be affected, talk to your doctor and pharmacy about other options.

* This medication is not available from another manufacturer, and you should discuss this with your doctor.
Extra Information Needed for Certain High-Cost Medicines:

Starting April 23, 2026, the following drugs will no longer be covered by NYRx without your doctor requesting approval. These drugs have alternate options available that do not require more information. Talk to your doctor or pharmacist about alternative drugs that do not require approval.

Drugs that will need this additional information:
Accrufer® 30mg Capsule
Carbinoxamine 4mg/5mL Solution
Desloratadine 0.5mg/mL Solution
Doxycycline Hyclate 50mg Tablet
Fenofibrate 120mg Tablet
Glimepiride 3mg Tablet
Lactulose 10g, 20g Packet
Methocarbamol 1,000mg Tablet
Tretinoin Gel Micro 0.08% Pump
Ursodiol 200mg, 400mg Capsule
How will you get these drugs?
You may still be able to get these drugs, but your doctor will have to submit additional information showing a clear health-related reason for use. Talk to your doctor or pharmacist to get more information.
Important Reminders
90-Day Supplies:Most drugs you take regularly are available as a 90-day supply. To get a 90-day supply, ask your doctor for a prescription. You can also talk to your pharmacist, who can speak to your doctor.

Stay Up to Date: To review current and past member notifications for NYRx, visit the 'Member Notices' section of the eMedNY member website.

Important Information About Your NY Medicaid Benefits:Make sure NY State of Health has your current mailing address, phone number and email address so they can contact you about your health insurance. Update your contact information at: NY State of Health Keep Your Coverage so you know when to renew your coverage.
Questions? We're Here to Help!
If you have any questions regarding your pharmacy benefits or NYRx, please call the Medicaid Helpline at (800) 541-2831. Our agents are available:
  • Monday through Friday, 8 AM to 8 PM
  • Saturday, 9 AM to 1 PM
TTY 1-800-662-1220. We also provide help in different languages.

Thank you,

NYRx, Medicaid Pharmacy Program
New York State Department of Health