www.mercycareplan.com                                  www.mercymaricopa.org
November 27, 2017
Oxycontin formulary removal effective 1/1/2018
Effective January 1, 2018, Oxycontin will be removed from the formulary for Mercy Care Plan and Mercy Maricopa Integrated Care. Xtampza ER will be added to the formulary with prior authorization in place of Oxycontin. Per AHCCCS we will NOT be grandfathering current utilizers of Oxycontin. We are requesting that you work with your patients currently on Oxycontin to be switched to Xtampza ER before 1/31/2018. If your patient cannot be switched to Xtampza ER, please submit a pharmacy prior authorization request that documents the medical necessity of Oxycontin over Xtampza ER for your particular member.

  • Current Prior Authorization approvals for Oxycontin will be updated to allow Xtampza ER to be filled starting 12/1/2017. 
  • Oxycontin fills will continue to process until 1/31/2018. 
  • Please refer to the prescribing information for conversion of Oxycodone to XTampza ER. 


As always, don't hesitate to contact your Mercy Care  or your Mercy Maricopa Provider Relations Representative with any questions or comments. You can find this notice and all other provider notices on our Mercy Care Plan or Mercy Maricopa website.   

Thanks for all you do!

QB 3159

www.mercycareplan.com                        www.mercymaricopa.org