Grant Wallace, director of the Employee Benefits Division, told the JBC-Employee Benefits Division—Oversight Subcommittee that the committee was reviewing standard formulary updates for January and February 2025 and recommended several exclusions and quantity-limit or tiering changes.

Wallace said the changes affect both pharmacy-dispensed medicines and drugs administered in clinical settings. "These are our normal formularies that you all, in ALC review, so now you get the pleasure of doing so today," he said. He added that most changes are related to "quantity limits, or some tiering updates" and that some newer products are being excluded "until there is more clinical evidence of the efficacy and value of adding them on."

The subcommittee heard two exclusion items highlighted by Wallace. He said the antidepressant Trintellix would be excluded for new starts because the division has identified "other alternatives that are more effective." He said 96 members currently using Trintellix will be kept on the drug under grandfathering provisions: "We are excluding this one. ... The 96 members that are impacted are being put on a lifetime grandfather. They will not be — we don't want to change anybody that is on this. We are just trying to move to other alternatives and not have any new starts with this particular drug."

Wallace also described an exclusion of a 360-milligram capsule referred to in the packet as "vorampil," which the division recommended excluding with a 90-day grandfather to allow transition to alternatives. On drugs given in clinical settings, Wallace said many of the items under review are new to market and therefore are being excluded pending further evidence. For some drugs, prior authorization requests will be managed by the division's consultant EBRx; Wallace said that when that occurs, "the prior authorization will actually go through our consultant EBRx and their criteria is managed through them, the advantage protocol, and aligns with FDA recommended coverage and protocols around those drugs."

Committee members asked for procedural clarifications. Senator Hickey asked how grandfathering would work in practice; Wallace said the 90-day grandfather period gives patients time to transition to alternatives and that if a patient moves off a drug during that period they would not be able to restart it. Reverend Graham, identified as a member of the public, asked whether alternatives always exist when the division excludes a drug; Wallace replied, "There would be. Yes." The transcript does not record further details about alternative medicines or which specific alternatives would be used.

The subcommittee approved the C1 package by voice vote. The minutes record a motion and second, and the chair called for "All in favor," members said "Aye," and the chair announced "Motion passes." The record does not give a roll-call tally or list dissenting votes.

The division's packet included the formulary change listings and notes on grandfathering periods and prior-authorization routing; no new statutory authorities or ordinance citations were presented during the discussion.