Headers - Salmon

Drug Formulary

If you have medications that are not currently on the Samish Approved Drug List, and would like them to be considered for addition, you may submit your request for consideration by the Pharmacy and Therapeutics Workgroup. You must use the Samish Formulary Request Form, which is located on the MEMBERS ONLY page of the website, or Purchased & Referred Care can send you a copy of the form. The Workgroup will meet as needed to review the requests.

Samish PRC is pleased to announce the following additions to the Samish Approved Drug List.

New additions for formulary effective 02/15/2020: 

  • Added--Ciclesonide (Alvesco)
  • Revised--Freestyle Libre 14-day Continuous Glucose Monitoring System will now be available to Type 2 Diabetics with preapproval from the Diabetes Program Manager

For questions about the PRC eligibility, pre-authorizations, program limitations, or general health coverage issues, please call our Contract Health Program at (877) 470-8737

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Dates: 22 – 22 Sep, 2020

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Dates: 24 – 24 Sep, 2020

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Dates: 29 – 29 Sep, 2020

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Dates: 01 – 01 Oct, 2020

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Dates: 08 – 08 Oct, 2020

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Dates: 13 – 13 Oct, 2020

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Dates: 20 – 20 Oct, 2020

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Dates: 22 – 22 Oct, 2020

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Dates: 27 – 27 Oct, 2020

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Dates: 29 – 29 Oct, 2020

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Dates: 03 – 03 Nov, 2020

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Dates: 05 – 05 Nov, 2020

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Dates: 12 – 12 Nov, 2020

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Dates: 15 – 15 Nov, 2020

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Dates: 17 – 17 Nov, 2020

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Dates: 18 – 18 Nov, 2020

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Dates: 19 – 19 Nov, 2020

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Dates: 01 – 01 Dec, 2020

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Dates: 03 – 03 Dec, 2020

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Dates: 08 – 08 Dec, 2020

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Dates: 10 – 10 Dec, 2020

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Dates: 15 – 15 Dec, 2020

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Dates: 17 – 17 Dec, 2020

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Dates: 13 Jan – 28 Apr, 2021

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