2026 Blue Rx PDP Complete (PDP) formulary (drug list)

Contract S5593, plan 003 · West Virginia · 3,788 drugs on file · formulary ID 00026017. Each drug links to its cost in every CMS PDP Region 06 plan.

15 drugs starting with Y.

Drug name	Tier	30-day preferred pharmacy	90-day mail order	Usage management
YARGESA 100 mg CapsuleMiglustat	5Specialty Tier	25%	N/A	PA QL 93 per 31 days
YESINTEK 45 mg/.5mL Injection, SolutionUstekinumab	3Preferred Brand	25%	25%	PA QL 0.5 per 84 days
YESINTEK 45 mg/.5mL Injection, SolutionUstekinumab	3Preferred Brand	25%	25%	PA QL 0.5 per 84 days
YESINTEK 90 mg/mL Injection, SolutionUstekinumab	5Specialty Tier	25%	N/A	PA QL 1 per 56 days
YF-VAX 4.74 [PFU]/.5mL Injection, Powder, Lyophilized, For SuspensionYellow Fever Virus Strain 17D-204 Live Antigen	3Preferred Brand	25%	25%	None
YONSA 125 mg TabletAbiraterone Acetate	5Specialty Tier	25%	N/A	PA QL 124 per 31 days
YORVIPATH 168 ug/.56mL Injection, SolutionPalopegteriparatide	5Specialty Tier	25%	N/A	PA QL 1.12 per 28 days
YORVIPATH 294 ug/.98mL Injection, SolutionPalopegteriparatide	5Specialty Tier	25%	N/A	PA QL 1.96 per 28 days
YORVIPATH 420 ug/1.4mL Injection, SolutionPalopegteriparatide	5Specialty Tier	25%	N/A	PA QL 2.8 per 28 days
YUFLYMA KitAdalimumab-Aaty	5Specialty Tier	25%	N/A	PA QL 2 per 28 days
YUFLYMA KitAdalimumab-Aaty	5Specialty Tier	25%	N/A	PA QL 6 per 365 days
YUFLYMA KitAdalimumab-Aaty	5Specialty Tier	25%	N/A	PA QL 2 per 28 days
YUFLYMA KitAdalimumab-Aaty	5Specialty Tier	25%	N/A	PA QL 2 per 28 days
YUPELRI 175 ug/3mL SolutionRevefenacin	5Specialty Tier	25%	N/A	PA
YUVAFEM 10 ug TabletEstradiol	4Non-Preferred Drug	25%	25%	None

PA = prior authorization, ST = step therapy, QL = quantity limit. Costs are the plan’s initial-coverage cost-sharing from the CMS 2026 formulary files; a drug not listed here is not on this plan’s formulary, though a formulary exception may still be possible.