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PDL Phase I Drug Classes – Preferred Drug Status Revised on January 1St of Each Year Antibiotic-Anti-Infective  Antibiotics, Inhaled  Antibiotics, Vaginal

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PDL Phase I Drug Classes – Preferred Drug Status Revised on January 1St of Each Year Antibiotic-Anti-Infective  Antibiotics, Inhaled  Antibiotics, Vaginal PDL Phase I Drug Classes – Preferred drug status revised on January 1st of each year Antibiotic-Anti-Infective Antibiotics, Inhaled Antibiotics, Vaginal Blood Modifiers Hereditary Angioedema (HAE) Cardiac Antihypertensives, Sympatholytics Angiotensin-Converting Enzyme Inhibitors (includes combination products) Angiotensin II Receptor Blockers (includes combination products) Beta blockers (includes combination products) Calcium Channel Blockers (includes dihydropyridine & non-dihydropyridine agents) Direct Renin inhibitors (including combination products) Lipotropics (includes Bile Acid Sequestrants, Cholesterol Absorption Inhibitor agent,Fibric Acid derivatives, HMG CoA Reductase Inhibitors-Statins Niacin derivatives, Niacin/Statin combinations,Microsomal Triglyceride Transfer Protein Inhibitor, Oligonucleotide Inhibitors and Omega 3 agents) Pulmonary Hypertension Agents (Includes Endothelin-1 agents, PDE-5 Inhibitors; Prostacyclin analogues, Prostacyclin Vasodilator, Soluble Guanylate Cyclase Stimulators ) Central Nervous System Alzheimer's Agents Anticonvulsants Antidepressants, Other & SSRI Antipsychotics Sedative Hypnotics (includes Benzodiazepine and Other Sedative Hypnotics) Dermatologic Agents Atopic Dermatitis- topical Steroids, Topical Endocrine and Metabolic Agents Glucocorticoids, Oral Growth Hormones Progestins for Cachexia Gastrointestinal Antiemetic/Antivertigo Agents Bile Salts H.pylori Treatment Histamine-2 Receptor Antagonists (H-2RA) Irritable Bowel Syndrome Proton Pump Inhibitors Ulcerative Colitis (includes oral and rectal) 2/16/2015 1 Genitourinary BPH treatment (include Alpha Blockers For BPH and Androgen Hormone Inhibitors & Phosphodiesterase (PDE) 5 Inhibitor) Phosphate Binders Bladder Relaxant Ophthalmic Antibiotic/Steroid Combinations Antibiotics Anti-Inflammatory Agents(includes Ophthalmic NSAIDS & Corticosteriods) Allergic Conjunctivitis (includes Ophthalmic Antihistamines & Mast Cell Stabilizers) Glaucoma Agents (includes Alpha-2 Adrenergic, Beta-blockers, Carbonic Anhydrase Inhibitors, Prostaglandin Inhibitors) Respiratory Anti-Allergens, Oral Antihistamines -Second Generation (LSAs) Beta Adrenergics– (includes short acting, long acting, nebulized and combinations) COPD: (includes Anticholinergics Bronchodilators and Phosphodiesterase 4 (PDE4) Inhibitors) Corticosteroids Inhaled (includes nebulized, metered dose and combinations) Epinephrine, Self-Injected Intranasal Corticosteroids & Antihistamines Leukotriene Modifiers and Inhibitors Legend Cough & Cold PDL Phase II Drug Classes – Preferred drug status revised on July 1st of each year Analgesics Barbiturate Analgesic & Non-salicylates analgesic (and combinations) Narcotics (Includes Long Acting , Short Acting and with combinations, Lozenges) Non-Steroidal Anti- Inflammatory Drugs (NSAID) ( includes Cox-2 Inhibitors) Opioid Analgesic & Dependency (includes Buprenorphine & Methadone) Topical Agents & Anesthetics Antibiotic-Anti-Infective Oral Antifungals Second and Third Generation Cephalosporins Second and Third Generation Quinolones – Systemic Macrolides - Adult and Pediatric Otic Quinolones Topical Antibiotics Antivirals Antivirals Herpes & Influenza Topical Antivirals Hepatitis C (moved to the spring 2015) Bone Resorption Supression and related Agents Bisphosphonates Calcitonins and Others 2/16/2015 2 Cardiac Anticoagulants (includs oral agentts, Low Molecular Weight Heparin and FactorXA Inhibitor) Platelet Aggregation Inhibitors Central Nervous System Antihyperkinesis/CNS Stimulants Non-Ergot Dopamine Receptor Agonists Antimigraine Skeletal Muscle Relaxants Smoking Cessation Dermatologic Agents Acne agents (includes Combination Benzoyl Peroxide & Clindamycin Products) Topical Retinoids & Combinations Topical Agents For Psoriasis Endocrine and Metabolic Agents Androgenic Agents Antihyperuricemics Contraceptives (Oral, Intra-vaginal. And Transdermal) Diabetic Injectable Hypoglycemics (includes all types of insulins, Incretin mimetics, Exenatide) Oral Hypoglycemics (includes 2nd generation sulfonylureas, alpha-glucosidase inhibitors, biguanides, biguanide combinations, meglitinides, thiazolidinediones, DPP-IV inhibitors and combinations Sodium- Glucose Cotransporter 2 (SGLT2) Inhibitor) Erythropoiesis Stimulating Proteins Progestational Agents Virginal/Oral Estrogens Immunological Agents Self Injectable Immunomodulators for RA Multiple Sclerosis Agents Potential new classes o Antibiotic-Anti-Infective Gastrointestinal o Endocrine and Metabolic Agents Pancreatic Enzymes o Dermatologic Antifungals: Topical 2/16/2015 3 .
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