Preferred Drug List Changes
The following changes have been made to the Nebraska PDL. Changes are effective January 20, 2023.
Nebraska PDL Therapeutic Drug Class | Brand Name (Route) | PDL Status before 1/20/23 | PDL status on and after 1/20/23 |
---|---|---|---|
ALZHEIMER'S AGENTS | RIVASTIGMINE (AG) (TRANSDERM.) | NON PREFERRED | PREFERRED |
ALZHEIMER'S AGENTS | RIVASTIGMINE (TRANSDERM.) | NON PREFERRED | PREFERRED |
ALZHEIMER'S AGENTS | EXELON (TRANSDERM.) | PREFERRED | NON PREFERRED |
ANTIHYPERTENSIVES, SYMPATHOLYTICS | CLONIDINE (TRANSDERM.) | NON PREFERRED | PREFERRED |
BRONCHODILATORS, BETA AGONIST | PROVENTIL HFA (INHALATION) | NON PREFERRED | PREFERRED |
BRONCHODILATORS, BETA AGONIST | VENTOLIN HFA (INHALATION) | NON PREFERRED | PREFERRED |
BRONCHODILATORS, BETA AGONIST | ALBUTEROL HFA (PROAIR) (AG) (INHALATION) | PREFERRED | NON PREFERRED |
BRONCHODILATORS, BETA AGONIST | ALBUTEROL HFA (PROAIR) (INHALATION) | PREFERRED | NON PREFERRED |
COLONY STIMULATING FACTORS | NYVEPRIA (SUBCUTANEOUS) | NON PREFERRED | PREFERRED |
CYTOKINE AND CAM ANTAGONISTS | COSENTYX PEN INJECTER (SUBCUTANE.) | NON PREFERRED | PREFERRED |
CYTOKINE AND CAM ANTAGONISTS | COSENTYX SYRINGE (SUBCUTANE.) | NON PREFERRED | PREFERRED |
EPINEPHRINE, SELF-INJECTED | EPIPEN (INTRAMUSC) | NON PREFERRED | PREFERRED |
EPINEPHRINE, SELF-INJECTED | EPIPEN JR (INTRAMUSC) | NON PREFERRED | PREFERRED |
ERYTHROPOIESIS STIMULATING PROTEINS | EPOGEN (INJECTION) | NON PREFERRED | PREFERRED |
ERYTHROPOIESIS STIMULATING PROTEINS | PROCRIT (INJECTION) | PREFERRED | NON PREFERRED |
IMMUNOMODULATORS, ATOPIC DERMATITIS | DUPIXENT PEN (SUBCUTANEOUS) | NON PREFERRED | PREFERRED |
IMMUNOMODULATORS, ATOPIC DERMATITIS | DUPIXENT SYRINGE (SUBCUTANEOUS) | NON PREFERRED | PREFERRED |
IMMUNOMODULATORS, ATOPIC DERMATITIS | PROTOPIC (TOPICAL) | NON PREFERRED | PREFERRED |
INTRANASAL RHINITIS AGENTS | FLUTICASONE OTC (NASAL) | PREFERRED | NON PREFERRED |
NSAIDS | DICLOFENAC (PENNSAID PUMP) (TOPICAL) | NON PREFERRED | PREFERRED |
NSAIDS | IBUPROFEN CAPSULE OTC (ORAL) | NON PREFERRED | PREFERRED |
ONCOLOGY, ORAL - BREAST | CAPECITABINE (ORAL) | NON PREFERRED | PREFERRED |
ONCOLOGY, ORAL - BREAST | IBRANCE CAPSULE (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - BREAST | IBRANCE TABLET (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - BREAST | XELODA (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - HEMATOLOGIC | IMBRUVICA CAPSULE (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - HEMATOLOGIC | IMBRUVICA TABLET (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - HEMATOLOGIC | JAKAFI (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - HEMATOLOGIC | SPRYCEL (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - HEMATOLOGIC | VENCLEXTA (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - HEMATOLOGIC | VENCLEXTA STARTING PACK (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - LUNG | ALECENSA (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - LUNG | TAGRISSO (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - OTHER | CAPRELSA (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - OTHER | LYNPARZA (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - OTHER | ZEJULA (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - PROSTATE | XTANDI CAPSULE (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - PROSTATE | XTANDI TABLET (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - PROSTATE | ZYTIGA (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - RENAL CELL | INLYTA (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - RENAL CELL | LENVIMA (ORAL) | PREFERRED | NON PREFERRED |
ONCOLOGY, ORAL - RENAL CELL | VOTRIENT (ORAL) | PREFERRED | NON PREFERRED |
OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS | OLOPATADINE DROPS (PATADAY) (OPHTHALMIC) | PREFERRED | NON PREFERRED |
OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS | OLOPATADINE OTC (PATADAY TWICE A DAY) (OPHTHALMIC) | PREFERRED | NON PREFERRED |
OTIC ANTIBIOTICS | CIPRO HC (OTIC) | NON PREFERRED | PREFERRED |
PROGESTATIONAL AGENTS | MAKENA AUTO INJECTOR (SUBCUTANEOUS) | PREFERRED | NON PREFERRED |
SICKLE CELL ANEMIA TREATMENTS | ENDARI (ORAL) | NON PREFERRED | PREFERRED |
STEROIDS, TOPICAL LOW | DERMA-SMOOTHE-FS (TOPICAL) | NON PREFERRED | PREFERRED |
STEROIDS, TOPICAL VERY HIGH | CLOBETASOL PROPIONATE GEL (TOPICAL) | PREFERRED | NON PREFERRED |
STIMULANTS AND RELATED AGENTS | DEXMETHYLPHENIDATE ER (AG) (ORAL) | NON PREFERRED | PREFERRED |
STIMULANTS AND RELATED AGENTS | DEXMETHYLPHENIDATE ER (ORAL) | NON PREFERRED | PREFERRED |
STIMULANTS AND RELATED AGENTS | QELBREE (ORAL) | NON PREFERRED | PREFERRED |
STIMULANTS AND RELATED AGENTS | FOCALIN XR (ORAL) | PREFERRED | NON PREFERRED |