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Sunshine Health Pharmacy Changes for Termination Labeler NDCs effective October 1, 2025

Date: 01/28/26

The following drug manufacturers voluntarily withdrew from the Medicaid Drug Rebate Program (MDRP). The Centers for Medicare and Medicaid Services (CMS), in compliance with Social Security Law Sec. 1927 [42 U.S.C. 1396r–8] (a), requires drug manufacturers to participate in the program for their drugs to be considered covered under the Medicaid Program. This agreement is required for drugs to be considered for coverage under the Medicaid program. View the announcement.

Because of this decision to withdraw, Medicaid Pharmacy Program will no longer cover the drugs made by the manufacturers listed below. Prescribers and pharmacies are encouraged to assist members with a therapeutically equivalent generic, obtain a new prescription for an available alternative, or consider the patient assistance program if eligible.

Manufacturers

NDC 5 -first 5 digits of the NDC (Labeler code)

Manufacturer Name

99207

BAUSCH HEALTH US, LLC

57782

BAUSCH HEALTH US, LLC

66490

BAUSCH HEALTH US, LLC

25010

BAUSCH HEALTH US, LLC

16781

BAUSCH HEALTH US, LLC

13548

BAUSCH HEALTH US, LLC

00187

BAUSCH HEALTH US, LLC

48102

FERA PHARMACEUTICALS, LLC

68682

OCEANSIDE PHARMACEUTICALS

65649

SALIX PHARMACEUTICALS, INC

68012

SANTARUS, INC.

41616

SUN PHARMA GLOBAL, INC.

29033

NOSTRUM LABORATORIES

29273

SALERNO PHARMACEUTICALS LP

51645

GEMINI PHARMACEUTICALS, INC. (dba Plus Pharma)

Medications impacted

  • Alendronate 5mg tabs
  • Altreno Lot 0.05%
  • *Anusol-HC CRE 2.5%
  • Aplenzin TAB 174MG
  • *Apriso Cap 0.375GM
  • Arazio lotion
  • *Ativan Tablets
  • *Atralin Gel
  • *Benzamycin Gel
  • Bryhali Lotion
  • Cabtreo Gel
  • *Cardizem CD capsules
  • *Cardizem LA Tablets
  • *Clindagel
  • +Cromolyn Nasal Spray
  • Diazepam 2.5mg Rectal Gel
  • Diuril Suspension
  • Duobrii Lotion
  • *Elidel Cream
  • *Glumetza ER Tablets
  • Hydrocortisone Buty Lipid Cream
  • Jublia Solution
  • *Librax Capsules
  • Locoid Lipocream
  • Luliconazole Cream
  • *Mestinon ER Tablets
  • *Mestinon Tablets Solution
  • *Migranal Nasal Spray
  • *Movieprep Packets
  • *Mysoline Tablets
  • Noritate Cream
  • *Onexton Gel Pump
  • *Pepcid Tablets
  • Phospholine Iodide Drops
  • Plenvu Packets
  • Relistor Tablets; Syringes; Vials
  • *Retin-A Cream
  • Retin-A Gel 0.1% PMP
  • Retin-A Micro Gel 0.06% PMP
  • Siliq Syringes
  • *Targretin Gel
  • *Theophylline ER Tablets 100mg; 200mg
  • Trulance Tablets
  • *Uceris ER Tablets
  • *Uceris Rectal Foam
  • *Vasotec Tablets
  • *Virazole Vials
  • Visudyne Vials
  • *Wellbutrin XL Tablets
  • Xerese Cream
  • Xifaxan Tablets
  • *Zegerid Packet & Caps
  • Zelapar ODT Tablets
  • *Ziana Gel
  • *Zyclara Cream         

* Generics for these drugs will remain available.

+ Over the counter product available

The below products have a patient assistance program option for Medicaid-only patients (PDF) by Bausch Health Companies Inc. For a complete list, please refer to the manufacturer websites.

  • Aplenzin  Tab 174mg
  • Arazlo Lot 0.045%
  • Bryhali Lotion
  • Cabtreo Gel
  • Diazepam  Gel 2.5mg
  • Duobrii Lotion
  • Jublia Sol 10%
  • Noritate Cre 1%
  • Relistor  Inj 12/0.6ml
  • Relistor Tab 150mg
  • Siliq Syringes
  • Trulance Tab 3mg
  • Xifaxan Tab 550mg
  • Zelapar ODT Tablets              

Thank you in advance for your attention to this matter. If you have questions, please call  Sunshine Health Provider Services at 1-844-477-8313, Monday through Friday, from 8 a.m. to 8 p.m. Eastern.

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