Member Important Updates on NYRx, the Medicaid Pharmacy Benefit

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

We hope you are doing 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 July 1, 2026, the following drug manufacturing companies will no longer be covered by NYRx:
Alexion Pharmaceuticals, INC.
Clovis Oncology, INC.
Eiger Biopharmaceuticals
Estiva Generics
Innovida Pharmaceutique Corporation
Pharmaceutica North America, INC.
Q Biomed, INC
Seton Pharmaceuticals, LLC
Sti Pharma, LLC
Vantive US Healthcare, LLC
Wyeth Pharmaceuticals, LLC
Xspire Pharma, LLC
Yiling Pharmaceutical, INC
Zambon USA, LTD
Other companies that make the same generic medicines are not affected. Your pharmacy may switch to a different company's version of the medicine and will let you know if this happens. The following drugs may be impacted:
Acetaminophen-caffeine-dihydrocodeine Capsule
Acyclovir Tablet
Anastrozole Tablet
Buspirone Tablet
Butalbital-acetaminophen-caffeine Capsule
Butalbital-acetaminophen Capsule
Celecoxib Capsule
Ciprofloxacin Otic & Tablet
Ciprofloxacin-fluocinolone Otic Solution
Clopidogrel Tablet
Dapsone Tablet
Dexamethasone Tablet
Diphenhydramine Solution
Docusate sodium Gelcap
Doxycycline Tablet
Escitalopram Tablet
Ethambutol Tablet
Felodipine Tablet
Fenoprofen Capsule & Tablet
Letrozole Tablet
Levamlodipine Tablet*
Lidocaine Cream
Memanthine Solution
Nalfon Capsule & Tablet
Pentamidine Inhalation & Injectable
Polyethylene glycol Powder
Prednisolone Solution
Sennosides Tablet
If you are taking one of the drugs above and are unsure if you will be affected, talk to your healthcare provider 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 July 16, 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:
Cephalexin 250mg, 500mg Tablet
Cephalexin 750mg Capsule
Clindamycin Phosphate 1% Foam
Clindamycin-Benzoyl Peroxide 1.2%-3.75% Gel
Clindamycin-Tretinoin 1.2%-0.025% Gel
Clonidine Hcl 0.05mg Tablet
Dexamethasone 0.25mg Tablet
Doxycycline Monohydrate 75mg, 150mg Capsule
Fenofibrate 50mg, 150mg Capsule
Fenoprofen 400mg, 600mg Tablet/Capsule
Folic Acid 0.2mg/ml Solution
Glipizide 15mg Tablet
Granisol™ 2mg/10ml Solution
Halobetasol 0.05% Foam
Indomethacin 25mg/5ml Suspension
Ketoprofen 200mg Capsule
Neo-Synalar® 0.5%-0.025% Cream
Tazarotene 0.1% Foam
Tolmetin Sodium 200mg Tablet
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.
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