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 you can access on this website if logged in as a Samish Tribal Citizen, or Purchased/Referred Care can send you a copy of the form. The Workgroup will meet as needed to review the requests.
Effective 08/01/2025, the following additions have been made to the Samish Approved Drug List:
Effective 04/09/2025, the following additions have been made to the Samish Approved Drug List:
- Gabapentin
- Ursodiol
- Xiidra eye drops
- Pancrelipase
- Xarelto
- Duloxetine
- Linzess
- Famotidine
- Letrozole
- Lansoprazole
Effective 04/02/2025, GLP-1 medications are no longer covered on the Samish Approved Drug List. GLP-1 medications include Ozempic, Wygovy, Trulicity, Victoza (liraglutide), Byetta (exenatide), Mounjaro (semaglutide), Zepbound, and Rybelsus (semaglutide).
Effective 02/28/2025, Ozempic is no longer a covered medication on the Samish Approved Drug List.
Samish PRC is pleased to announce the following additions to the Samish Approved Drug List.
New additions to the Samish Drug Formulary effective 01/01/2025:
- Paxlovid
- Colestipol
- Replacing True Metrix with Easy Touch testing supplies
New additions to the Samish Drug Formulary effective 11/01/2024:
- Lamotrigine all strengths
- Scopolamine patches
- Ezetimibe 10mg
- Budesonide/Formoterol Fumarate Dihydrate
- Tirzepatide
New additions to the Samish Drug Formulary effective 8/1/2024:
New additions to the Samish Drug Formulary effective 5/1/2024:
- Calcipotriene Topical Ointment
- Sotalol Tablets
New additions for Samish Drug Formulary effective 11/15/2023:
- Isotretinoin
- Trelegy Ellipta
- Dapagliflozin
New additions for Samish Drug Formulary effective 07/01/2023:
- Dexcom CGM
- Apixaban (generic of Eliquis)
- Cefpodoxime
- Albuterol/ipratropium (generic of Combivent)
- Modafinil (generic of Provigil)
New additions for Samish Drug Formulary effective 06/01/2022:
- Cimetidine 400 mg tablets
- Methotrexate Injectable 25 ml vials only
- Semaglutide Injectable
Additions and changes to the Samish Drug Formulary effective 08/01/2021
Added:
- Rybelsus (semaglutide)
- Dexilant (dexlansoprazole)
- 5% Lidocaine patch
Updated:
- NovoLog (insulin aspart) Make Novolog the preferred fast-acting insulin, unless physician confirms no substitute allowed
Declined due to high cost:
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