Preferred Drug List Changes
The following changes have been made to the Nebraska PDL. Changes are effective July 18, 2025.
| Nebraska PDL Therapeutic Drug Class | Drug Name (Route) | PDL Status before 7/18/25 | PDL status on or after 7/18/25 |
|---|---|---|---|
| ACNE AGENTS, TOPICAL | DIFFERIN CREAM (TOPICAL) | Preferred | Non Preferred |
| ACNE AGENTS, TOPICAL | DIFFERIN GEL PUMP (TOPICAL) | Preferred | Non Preferred |
| ACNE AGENTS, TOPICAL | DIFFERIN LOTION (TOPICAL) | Preferred | Non Preferred |
| ANGIOTENSIN MODULATOR COMBINATIONS | AMLODIPINE / VALSARTAN / HCTZ (ORAL) | Preferred | Non Preferred |
| ANGIOTENSIN MODULATORS | BENAZEPRIL HCTZ (ORAL) | Preferred | Non Preferred |
| ANGIOTENSIN MODULATORS | QUINAPRIL (ORAL) | Preferred | Non Preferred |
| ANGIOTENSIN MODULATORS | QUINAPRIL HCTZ (AG) (ORAL) | Preferred | Non Preferred |
| ANGIOTENSIN MODULATORS | QUINAPRIL HCTZ (ORAL) | Preferred | Non Preferred |
| ANTIBIOTICS, GI | VANCOMYCIN SOLUTION (FIRVANQ) (AG) (ORAL) | Non Preferred | Preferred |
| ANTIBIOTICS, GI | VANCOMYCIN SOLUTION (FIRVANQ) (ORAL) | Non Preferred | Preferred |
| ANTIBIOTICS, GI | FIRVANQ (ORAL) | Preferred | Non Preferred |
| ANTIBIOTICS, TOPICAL | BACITRACIN PACKET OTC (TOPICAL) | Preferred | Non Preferred |
| ANTIBIOTICS, VAGINAL | CLEOCIN CREAM (VAGINAL) | Non Preferred | Preferred |
| ANTIBIOTICS, VAGINAL | CLINDAMYCIN (VAGINAL) | Preferred | Non Preferred |
| ANTIEMETIC/ANTIVERTIGO AGENTS | TRANSDERM-SCOP (TRANSDERM) | Non Preferred | Preferred |
| ANTIFUNGALS, ORAL | NYSTATIN TABLET (ORAL) | Preferred | Non Preferred |
| ANTIFUNGALS, TOPICAL | CLOTRIMAZOLE SOLUTION RX (TOPICAL) | Non Preferred | Preferred |
| ANTIFUNGALS, TOPICAL | CLOTRIMAZOLE SOLUTION OTC (TOPICAL) | Preferred | Non Preferred |
| ANTIMIGRAINE AGENTS, TRIPTANS | SUMATRIPTAN KIT (AG) (SUBCUTANE.) | Preferred | Non Preferred |
| ANTIMIGRAINE AGENTS, TRIPTANS | SUMATRIPTAN KIT (SUBCUTANE.) | Preferred | Non Preferred |
| ANTIMIGRAINE AGENTS, TRIPTANS | SUMATRIPTAN KIT (SUN) (SUBCUTANE.) | Preferred | Non Preferred |
| BETA-BLOCKERS | BYSTOLIC (ORAL) | Preferred | Non Preferred |
| DIURETICS | KERENDIA (ORAL) | Non Preferred | Preferred |
| FLUOROQUINOLONES, ORAL | MOXIFLOXACIN (ORAL) | Non Preferred | Preferred |
| GI MOTILITY, CHRONIC | LUBIPROSTONE (AG) (ORAL) | Non Preferred | Preferred |
| GI MOTILITY, CHRONIC | LUBIPROSTONE (ORAL) | Non Preferred | Preferred |
| GI MOTILITY, CHRONIC | AMITIZA (ORAL) | Preferred | Non Preferred |
| GI MOTILITY, CHRONIC | MOVANTIK (ORAL) | Preferred | Non Preferred |
| GLUCAGON AGENTS | GLUCAGON EMERGENCY KIT (FRESENIUS) (INJECTION) | Non Preferred | Preferred |
| GLUCAGON AGENTS | GVOKE PEN (SUBCUTANEOUS) | Non Preferred | Preferred |
| GLUCAGON AGENTS | GVOKE SYRINGE (SUBCUTANEOUS) | Non Preferred | Preferred |
| HAE TREATMENTS | TAKHZYRO SYRINGE (SUB-Q) | Non Preferred | Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | INSULIN LISPRO PROTAMINE MIX KWIKPEN (AG) (SUBCUTANEOUS) | Non Preferred | Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | APIDRA SOLOSTAR PEN (SUBCUTANE.) | Preferred | Non Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | APIDRA VIAL (SUBCUTANE.) | Preferred | Non Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | HUMALOG CARTRIDGE (SUBCUTANE.) | Preferred | Non Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | HUMALOG JUNIOR KWIKPEN (SUBCUTANE.) | Preferred | Non Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | HUMALOG MIX PEN (SUBCUTANE.) | Preferred | Non Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | HUMALOG MIX VIAL (SUBCUTANE.) | Preferred | Non Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | HUMALOG PEN (SUBCUTANE.) | Preferred | Non Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | HUMALOG VIAL (SUBCUTANE.) | Preferred | Non Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | INSULIN GLARGINE PEN (SUBCUTANE.) | Preferred | Non Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | INSULIN GLARGINE VIAL (SUBCUTANE.) | Preferred | Non Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | LEVEMIR PENS (SUBCUTANE.) | Preferred | Non Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | LEVEMIR VIAL (SUBCUTANE.) | Preferred | Non Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | NOVOLIN PEN OTC (SUBCUTANEOUS) | Preferred | Non Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | NOVOLOG CARTRIDGE (SUBCUTANE.) | Preferred | Non Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | NOVOLOG MIX PEN (SUBCUTANE.) | Preferred | Non Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | NOVOLOG PEN (SUBCUTANE.) | Preferred | Non Preferred |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | NOVOLOG VIAL (SUBCUTANE.) | Preferred | Non Preferred |
| HYPOGLYCEMICS, SGLT2 | INVOKAMET (ORAL) | Preferred | Non Preferred |
| HYPOGLYCEMICS, SGLT2 | INVOKANA (ORAL) | Preferred | Non Preferred |
| HYPOGLYCEMICS, SULFONYLUREAS | GLIMEPIRIDE 3MG (ORAL) | Preferred | Non Preferred |
| IMMUNOSUPPRESSIVES, ORAL | MYCOPHENOLIC ACID (ORAL) | Non Preferred | Preferred |
| LIPOTROPICS, OTHER | REPATHA SURECLICK (SUBCUTANEOUS) | Non Preferred | Preferred |
| LIPOTROPICS, OTHER | REPATHA SYRINGE (SUBCUTANEOUS) | Non Preferred | Preferred |
| MULTIPLE SCLEROSIS AGENTS | BETASERON KIT (SUBCUTANE.) | Preferred | Non Preferred |
| MULTIPLE SCLEROSIS AGENTS | DIMETHYL FUMARATE DR STARTER PACK (ORAL) | Preferred | Non Preferred |
| OPIATE DEPENDENCE TREATMENTS | NARCAN SPRAY OTC (NASAL) | Non Preferred | Preferred |
| OPIATE DEPENDENCE TREATMENTS | NALOXONE SYRINGE (INJECTION) | Preferred | Non Preferred |
| PAH AGENTS, ORAL AND INHALED | TYVASO (INHALATION) | Preferred | Non Preferred |
| PAH AGENTS, ORAL AND INHALED | VENTAVIS (INHALATION) | Preferred | Non Preferred |
| PHOSPHATE BINDERS | CALPHRON (ORAL) | Preferred | Non Preferred |
| PRENATAL VITAMINS | PNV 11-IRON FUM-FOLIC ACID-OM3 (ORAL) | Preferred | Non Preferred |
| PROTON PUMP INHIBITORS | RABEPRAZOLE TABLETS (ORAL) | Preferred | Non Preferred |
| TETRACYCLINES | MINOCYCLINE TABLETS (ORAL) | Non Preferred | Preferred |
| TETRACYCLINES | DOXYCYCLINE HYCLATE TABLET (ORAL) | Preferred | Non Preferred |
| TETRACYCLINES | DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE (AG) (ORAL) | Preferred | Non Preferred |
| TETRACYCLINES | DOXYCYCLINE MONOHYDRATE 100 MG CAPSULE (ORAL) | Preferred | Non Preferred |
| TETRACYCLINES | DOXYCYCLINE MONOHYDRATE 50 MG CAPSULE (AG) (ORAL) | Preferred | Non Preferred |
| TETRACYCLINES | DOXYCYCLINE MONOHYDRATE 50 MG CAPSULE (ORAL) | Preferred | Non Preferred |
| TETRACYCLINES | MINOCYCLINE CAPSULES (ORAL) | Preferred | Non Preferred |
| ULCERATIVE COLITIS AGENTS | MESALAMINE (LIALDA) (AG) (ORAL) | Non Preferred | Preferred |
| ULCERATIVE COLITIS AGENTS | MESALAMINE (LIALDA) (ORAL) | Non Preferred | Preferred |
| ULCERATIVE COLITIS AGENTS | LIALDA (ORAL) | Preferred | Non Preferred |