Drug Class
|
Drug Name
|
Change
|
Alzheimer’s
|
Entire class
|
Client must have tried and failed, or is intolerant to, all preferred products before receiving a non-preferred product for the same indication.
|
Antiemetics
|
Entire class
|
Client must have tried and failed, or is intolerant to, all preferred products before receiving a non-preferred product for the same indication.
|
Antiplatelets
|
Entire class
|
Client must have tried and failed, or is intolerant to, all preferred products before receiving a non-preferred product for the same indication.
|
Attention Deficit/
Hyperactivity Disorder
|
Entire class
|
Client must have tried and failed, or is intolerant to, all preferred products before receiving a non-preferred product for the same indication.
|
Atypical Antipsychotics
|
Entire class
|
Changed title of drug class to “Second Generation Antipsychotics”
|
Atypical Antipsychotics
(Second Generation Antipsychotics)
|
Entire class
|
Client must have tried and failed, or is intolerant to, 3 preferred products for the same indication before receiving a non-preferred product.
|
Atypical Antipsychotics
(Second Generation Antipsychotics)
|
Abilify® IM injection
|
Removed, no longer manufactured
|
Atypical Antipsychotics
(Second Generation Antipsychotics)
|
Abilify® solution
|
Removed, no longer manufactured
|
Atypical Antipsychotics
(Second Generation Antipsychotics)
|
Abilify® tablets
|
Non-Preferred
|
Atypical Antipsychotics
(Second Generation Antipsychotics)
|
Abilify® Discmelt
|
Removed, no longer manufactured
|
Atypical Antipsychotics
(Second Generation Antipsychotics)
|
Aristada®
|
Preferred
|
Atypical Antipsychotics
(Second Generation Antipsychotics)
|
Invega Trinza®
|
Preferred
|
Atypical Antipsychotics
(Second Generation Antipsychotics)
|
Rexulti®
|
Preferred
|
Atypical Antipsychotics
(Second Generation Antipsychotics)
|
Seroquel® / XR®
|
Non-Preferred
|
Atypical Antipsychotics
(Second Generation Antipsychotics)
|
Vraylar®
|
Preferred
|
Atypical Antipsychotics
(Second Generation Antipsychotics)
|
Zyprexa® IM injection
|
Non-Preferred
|
Long-Acting Insulins
|
Entire class
|
Client must have tried and failed, or is intolerant to, all preferred products before receiving a non-preferred product for the same indication.
|
Nasal Corticosteroids
|
Entire class
|
Client must have tried and failed, or is intolerant to, all preferred products before receiving a non-preferred product for the same indication.
|
Newer Sedative/ Hypnotics
|
Entire class
|
Changed title of drug class to “Insomnia”. Added subclasses. Removed all EA and PA requirements, only PDL rules apply. Client must have tried and failed, or is intolerant to, all preferred products before receiving a non-preferred product for the same indication.
|
Targeted Immune Modulators
|
Inflectra®
|
Added to class as non-preferred, unstudied, not subject to TIP/DAW.
|
Targeted Immune Modulators
|
Entire class
|
Removed all EA and PA requirements, only PDL rules apply. Client must have tried and failed, or is intolerant to, all preferred products before receiving a non-preferred product for the same indication.
|