AHCCCS Pharmacy Information

Pharmacy Updates

Biosimilar Updates (Effective August 1, 2025)

AHCCCS posted a biosimilar memo for biosimilar drug changes that will become effective on August 1, 2025. These changes were announced at the May AHCCCS Pharmacy & Therapeutics Committee Meeting and were also posted on the AHCCCS website under the Pharmacy & Therapeutics Committee section under Pharmacy.

AHCCCS MCO Contractors and the AHCCCS FFS Program will begin to transition members from the brand name medication to the AHCCCS FDA approved preferred biosimilar on August 1, 2025.

For claims that are dispensed by a retail pharmacy, the brand name medication will be rejected at the pharmacy with messaging to use the biosimilar. When a biosimilar is approved by the FDA as interchangeable with the brand name product, the pharmacist can make this prescription change without contacting the prescribing clinician. When the preferred biosimilar medication does not have the interchangeable designation by the FDA, the pharmacist will have to contact the prescribing clinician for approval to dispense the preferred biosimilar.

For medical claims, the HCPCS codes for the brand name agents and non-preferred biosimilars will be closed by end-of-business day on September 30th and will no longer be covered effective October 1, 2025.

AHCCCS Biosimilar Update Memo - Updated 8/5/2025

Clozapine Risk Evaluation and Mitigation Strategies Program Update (Effective February 24, 2025)

The U.S. Food & Drug Administration (FDA) announced that prescribing clinicians and pharmacies are no longer required to upload patient data, including registration details and absolute neutrophil count (ANC) lab results, to the Clozapine Risk Evaluation and Mitigation Strategies (REMS) program. However, the FDA continues to recommend that prescribers monitor patients’ ANC as outlined in the prescribing information. The FDA will collaborate with clozapine manufacturers in the coming months to update the prescribing information and work toward eliminating the clozapine REMS program entirely.

Read more from the FDA...

Sublocade & Brixadi

AHCCCS is rescinding the buy and bill requirement for Sublocade and Brixadi effective October 7, 2024. For additional inquiries, please email the pharmacy department at AHCCCSPharmacyDept@azahcccs.gov

Arizona Complete Health-Complete Care Plan (AzCH-CCP) ACC-RBHA

Arizona Complete Health - Pharmacy

When you visit this page, scroll down to where it says, “How to get your Prescriptions.” Click the plus sign to see additional information in this section. Click the Express Scripts link under the following section: Non-Title AHCCCS Enrollees assigned to AzCH-CCP can find Pharmacy Benefit details by logging into the Express Scripts website. When you register or log in, you will be able to see your pharmacy information, including your member ID card.

Mercy Care ACC-RBHA

Mercy Care ACC‑RBHA with SMI

When you visit this page, scroll down where it says, “Member portal.” Click the link that prompts you to register for the web portal. When you register or log in, you will be able to see your member ID card. You will also be able to see it on your mobile device.

The AHCCCS Pharmacy & Therapeutics Committee (Committee) is advisory to the AHCCCS Administration and is responsible for evaluating scientific evidence of the relative safety, efficacy, effectiveness and clinical appropriateness of prescription drugs. The Committee makes recommendations to the AHCCCS Administration on the development and maintenance of a statewide drug list and prior authorization criteria as appropriate. The Committee may also evaluate individual drugs and therapeutic classes of drugs.

The meetings are open to the public.

P&T Meeting Public Testimony, for persons that are not representing a pharmaceutical company, pharmacy benefit manager or related entity, may be given orally or submitted as a written document in accordance with the AHCCCS P&T Operational Policy

Each person must fill out the Public Testimony Registration Form and the Conflict of Interest Form to register for the meeting. See the AHCCCS P&T Operational Policy for deadlines.

Magellan Medicaid Administration, Inc. (MMA), part of the Magellan Rx Management division of Prime Therapeutics LLC, has been selected to manage the preferred drug list (PDL) and supplemental rebate processes. Please see the MagellanRX Management site for more information.

P&T Meeting and Class Review Schedule

Agendas & Meeting Minutes

ANNOUNCEMENT: All AHCCCS P&T meetings will be held virtually until further notice.

Current P&T Committee Member Information

P&T Application - Now Accepting New Members

The AHCCCS Pharmacy and Therapeutics Committee is now accepting new members for the following positions:

  • Health Care Providers - 1 Representative
  • Public - 2 Representatives (Inter-Tribal Council of Arizona and Medicaid Member)
  • AHCCCS MCO's and TRBHA - 2 Representatives (TRBHA Pharmacy Director and/or TRBHA Medical Director)

Please fill out the P&T Application and send to the Arizona Pharmacy Department ( AHCCCSPharmacyDept@azahcccs.gov ) for consideration.

For more information, you may contact the Pharmacy Department at AHCCCSPHARMACYDEPT@AZAHCCCS.GOV.

Archived pharmacy documents are available under ‘Pharmacy Updates’ in the AHCCCS Document Archive.