Preferred Drug List Changes
The following changes have been made to the Nebraska PDL. Changes are effective July 21, 2023.
| Nebraska PDL Therapeutic Drug Class | Brand Name (Route) | PDL Status before 07/21/23 | PDL status on and after 07/21/23 |
|---|---|---|---|
| ACNE AGENTS, TOPICAL | ADAPALENE CREAM (TOPICAL) | NON PREFERRED | PREFERRED |
| ACNE AGENTS, TOPICAL | ADAPALENE GEL (AG) (TOPICAL) | NON PREFERRED | PREFERRED |
| ACNE AGENTS, TOPICAL | ADAPALENE GEL (TOPICAL) | NON PREFERRED | PREFERRED |
| ACNE AGENTS, TOPICAL | ADAPALENE GEL OTC (TOPICAL) | NON PREFERRED | PREFERRED |
| ACNE AGENTS, TOPICAL | ADAPALENE GEL PUMP (AG) (TOPICAL) | NON PREFERRED | PREFERRED |
| ACNE AGENTS, TOPICAL | ADAPALENE GEL PUMP (TOPICAL) | NON PREFERRED | PREFERRED |
| ANALGESICS, NARCOTICS LONG | XTAMPZA ER (ORAL) | NON PREFERRED | PREFERRED |
| ANALGESICS, NARCOTICS SHORT | TRAMADOL / APAP (ORAL) | PREFERRED | NON PREFERRED |
| ANGIOTENSIN MODULATOR COMBINATIONS | AMLODIPINE / VALSARTAN / HCTZ (ORAL) | NON PREFERRED | PREFERRED |
| ANTIBIOTICS, INHALED | TOBRAMYCIN (TOBI) (INHALATION) | NON PREFERRED | PREFERRED |
| ANTIEMETIC/ANTIVERTIGO AGENTS | APREPITANT CAPSULE (ORAL) | NON PREFERRED | PREFERRED |
| ANTIEMETIC/ANTIVERTIGO AGENTS | EMEND CAPSULE (ORAL) | PREFERRED | NON PREFERRED |
| ANTIEMETIC/ANTIVERTIGO AGENTS | EMEND PACK (ORAL) | PREFERRED | NON PREFERRED |
| BETA-BLOCKERS | BYSTOLIC (ORAL) | NON PREFERRED | PREFERRED |
| BLADDER RELAXANT PREPARATIONS | MYRBETRIQ (ORAL) | NON PREFERRED | PREFERRED |
| BLADDER RELAXANT PREPARATIONS | SOLIFENACIN (ORAL) | PREFERRED | NON PREFERRED |
| CONTRACEPTIVES, ORAL | FINZALA FE (ORAL) | NON PREFERRED | PREFERRED |
| CONTRACEPTIVES, ORAL | HER STYLE OTC (ORAL) | NON PREFERRED | PREFERRED |
| CONTRACEPTIVES, ORAL | NORETHINDRONE/ETHINYL ESTRADIOL FE ESTROPHASIC (ESTROSTEP FE) (ORAL) | NON PREFERRED | PREFERRED |
| GI MOTILITY, CHRONIC | RELISTOR SYRINGE (SUBCUTANE.) | NON PREFERRED | PREFERRED |
| GLUCAGON AGENTS | ZEGALOGUE AUTOINJECTOR (SUBCUTANEOUS) | NON PREFERRED | PREFERRED |
| HIV / AIDS | EDURANT (ORAL) | NON PREFERRED | PREFERRED |
| HIV / AIDS | JULUCA (ORAL) | NON PREFERRED | PREFERRED |
| HIV / AIDS | LOPINAVIR/RITONAVIR TABLET (ORAL) | NON PREFERRED | PREFERRED |
| HIV / AIDS | NORVIR TABLET (ORAL) | NON PREFERRED | PREFERRED |
| HIV / AIDS | RITONAVIR TABLET (ORAL) | PREFERRED | NON PREFERRED |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | APIDRA SOLOSTAR PEN (SUBCUTANE.) | NON PREFERRED | PREFERRED |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | APIDRA VIAL (SUBCUTANE.) | NON PREFERRED | PREFERRED |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | INSULIN GLARGINE PEN (SUBCUTANE.) | NON PREFERRED | PREFERRED |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | INSULIN GLARGINE VIAL (SUBCUTANE.) | NON PREFERRED | PREFERRED |
| HYPOGLYCEMICS, INSULIN AND RELATED AGENTS | INSULIN LISPRO PROTAMINE MIX KWIKPEN (AG) (SUBCUTANEOUS) | PREFERRED | NON PREFERRED |
| LIPOTROPICS, OTHER | PRALUENT PEN (SUBCUTANEOUS) | NON PREFERRED | PREFERRED |
| LIPOTROPICS, OTHER | VASCEPA (ORAL) | NON PREFERRED | PREFERRED |
| MULTIPLE SCLEROSIS AGENTS | FINGOLIMOD (ORAL) | NON PREFERRED | PREFERRED |
| MULTIPLE SCLEROSIS AGENTS | TERIFLUNOMIDE TABLET (ORAL) | NON PREFERRED | PREFERRED |
| OPIATE DEPENDENCE TREATMENTS | NALOXONE SPRAY (AG) (NASAL) | NON PREFERRED | PREFERRED |
| OPIATE DEPENDENCE TREATMENTS | NALOXONE SPRAY (NASAL) | NON PREFERRED | PREFERRED |
| OPIATE DEPENDENCE TREATMENTS | NARCAN SPRAY (NASAL) | PREFERRED | NON PREFERRED |
| PEDIATRIC VITAMIN PREPARATIONS | POLY-VI-SOL DROPS OTC (ORAL) | NON PREFERRED | PREFERRED |
| PHOSPHATE BINDERS | RENVELA POWDER PACK (ORAL) | NON PREFERRED | PREFERRED |
| PRENATAL VITAMINS | PRENATAL VIT/FE FUMARATE/FA OTC (ORAL) | NON PREFERRED | PREFERRED |
| PRENATAL VITAMINS | PNV WITH CA NO.68/IRON/FA NO.1/DHA (ORAL) | PREFERRED | NON PREFERRED |
| PROTON PUMP INHIBITORS | DEXILANT (ORAL) | NON PREFERRED | PREFERRED |
| TETRACYCLINES | MINOCYCLINE TABLETS (ORAL) | PREFERRED | NON PREFERRED |
| ULCERATIVE COLITIS AGENTS | MESALAMINE (CANASA) (AG) (RECTAL) | NON PREFERRED | PREFERRED |
| ULCERATIVE COLITIS AGENTS | MESALAMINE (CANASA) (RECTAL) | NON PREFERRED | PREFERRED |
| ULCERATIVE COLITIS AGENTS | SFROWASA (RECTAL) | NON PREFERRED | PREFERRED |
| ULCERATIVE COLITIS AGENTS | CANASA (RECTAL) | PREFERRED | NON PREFERRED |
| ULCERATIVE COLITIS AGENTS | ROWASA (RECTAL) | PREFERRED | NON PREFERRED |
| VASODILATORS, CORONARY | BIDIL (ORAL) | NON PREFERRED | PREFERRED |