PDL Drug Class Review Announcement July 13, 2021 Drug Classes to be reviewed: Anticonvulsants, Oral; Stimulants and other ADHD Agents; Bone Resorption Suppression & Related Agents; Contraceptives (Oral & Topical); Estrogen Agents (Injectable, Oral/Transdermal); Diabetes Management Agents (Amylin, Biguanides, DPP-4 Inhibitors, GLP-1 Analogues, Hypoglycemic Combinations, Insulins, Meglitinides, SGLT-2 Inhibitors, Thiazolidinediones); Glucagon, Self-Administered; GI Motility (Chronic); Anticoagulants (Oral & Parenteral); Antiplatelet Agents; Colony Stimulating Factors; Erythropoiesis Stimulating Agents; Newer Hereditary Angioedema Agents; Ophthalmic Immunomodulators; Overactive Bladder Agents, and Prenatal Vitamins. These drug classes will be reviewed at the July 13th, 2021 P&T Committee meeting from 1-5pm. The meeting will be held virtually. Dossiers and Supplemental Rebate offers are due to Magellan by June 15, 2021. Interested parties who want to present at the meeting shall give advanced notice and provide a one-page summary of the clinical information that will be presented for P&T Committee dissemination. Please contact Jessica Czechowski, Pharmacist Account Executive, [email protected] and carbon copy Brittany Schock, PDL & Clinical Strategy Pharmacist, at 303-866-6371 or by email at [email protected] to give advance notice to present at the meeting. Advance notice requests to present and/or written public comments can be submitted to and will be distributed to P&T Committee Members, once approved. Please provide public comments no later than July 6, 2021 by 5pm MT to ensure they are reviewed for inclusion in the information supplied to the P&T Committee members. Policies surrounding stakeholder comment can be found at: https://www.colorado.gov/pacific/hcpf/pharmacy-and- therapeutics-committee ANTICONVULSANTS: Oral Brand Name Generic Name Phenobarbital elixir, solution, tablet Valproic Acid capsule, solution Zonisamide capsule Aptiom Eslicarbazepine tablet Banzel Rufinamide suspension, tablet Rufinamide suspension Briviact Brivaracetam solution, tablet Carbatrol ER Carbamazepine ER capsule Carbamazepine ER capsule Celontin Methsuximide Kapseal Depakote Divalproex Sodium capsule, sprinkle capsule, DR tablet, ER tablet Divalproex Sodium capsule, sprinkle capsule, DR tablet, ER tablet Diacomit Stiripentol capsule, powder packet Dilantin Phenytoin ER capsule, Infatab, suspension Phenytoin ER capsule, chewable tablet, suspension Elepsia XR Levetiracetam ER tablet Epidiolex Cannabidiol (CBD) solution Epitol Carbamazepine tablet Equetro Carbamazepine capsule Felbatol Felbamate suspension, tablet Felbamate suspension, tablet Fintepla Fenfluramine solution Fycompa Perampanel tablet, suspension Gabitril Tiagabine tablet Tiagabine tablet Keppra, Keppra XR Levetiracetam solution, tablet, ER tablet Levetiracetam solution, tablet, ER tablet Klonopin Clonazepam tablet Clonazepam tablet, ODT/Dispersable tablet Lamictal, Lamictal XR Lamotrigine tablet, dispersable tablet, starter kit, ODT, ODT kit, ER tablet, ER kit Lamotrigine tablet, dispersable tablet, starter kit, ODT, ODT kit, ER tablet, ER kit Mysoline Primidone tablet Primidone tablet Onfi Clobazam suspension, tablet Clobazam suspension, tablet Oxtellar XR Oxcarbazepine ER tablet Peganone Ethotoin tablet Phenytek Phenytoin ER capsule Qudexy XR Topiramate ER capsule Topiramate ER capsule Roweepra/Roweepra XR Levetiracetam tablet, ER tablet Sabril Vigabatrin powder packet, tablet Vigabatrin powder packet, tablet Spritam Levetiracetam tablet Subvenite Lamotrigine tablet Sympazan Clobazam film Tegretol, Tegretol XR Carbamazepine suspension, tablet Carbamazepine chewable tablet, suspension, tablet, ER tablet Topamax Topiramate tablet, sprinkle capsule Topiramate tablet, sprinkle capsule Trileptal Oxcarbazepine suspension, tablet Oxcarbazepine suspension, tablet Trokendi XR Topiramate ER capsule Vimpat Lacosamide solution, starter kit, tablet Xcopri Cenobamate tablet, titration pack, daily dose pack Zarontin Ethosuximide capsule, solution Ethosuximide capsule, solution STIMULANTS and other ADHD Agents Brand Name Generic Name Clonidine ER tablet Dextroamphetamine tablet Methylphenidate chewable tablet Methylphenidate CD/ER capsule Methylphenidate ER 72mg tablet Adderall/Adderall XR Dextroamphetamine/amphetamine tablet, ER capsule Dextroamphetamine/amphetamine tablet, ER capsule Adhansia XR Methylphenidate ER capsule Adzenys ER Amphetamine ER suspension Amphetamine ER suspension Adzenys XR-ODT Amphetamine ER ODT Aptensio XR Methylphenidate ER capsule Methylphenidate ER capsule Concerta Methylphenidate ER tablet Methylphenidate ER tablet Cotempla XR-ODT Methylphenidate ODT Daytrana Methylphenidate patch Desoxyn Methamphetamine tablet Methamphetamine tablet Dexedrine Dextroamphetamine spansule Dextroamphetamine ER capsule Dyanavel XR Amphetamine ER suspension Evekeo Amphetamine tablet, ODT Amphetamine tablet Focalin/Focalin XR Dexmethylphenidate tablet, ER capsule Dexmethylphenidate tablet, ER capsule Intuniv ER Guanfacine ER tablet Guanfacine ER tablet Jornay PM Methylphenidate ER capsule Methylin Methylphenidate solution Methylphenidate solution Mydayis ER Dextroamphetamine/Amphetamine capsule Nuvigil Armodafinil tablet Armodafinil tablet Procentra Dextroamphetamine solution Dextroamphetamine solution Provigil Modafinil tablet Modafinil tablet Qelbree Viloxazine capsule Quillichew ER Methylphenidate ER chewable tablet Quillivant XR Methylphenidate ER suspension Relexxi ER Methylphenidate ER tablet Methylphenidate ER tablet Ritalin/Ritalin LA/Ritalin SR Methylphenidate tablet, ER tablet, LA capsule Methylphenidate tablet, ER tablet, ER/LA capsule Strattera Atomoxetine capsule Atomoxetine capsule Sunosi Solriamfetol tablet Vyvanse Lisdexamfetamine capsule, chewable tablet Wakix Pitolisant tablet Zenzedi Dextroamphetamine tablet Dextroamphetamine tablet BONE RESORPTION SUPPRESSION & RELATED AGENTS Brand Name Generic Name Bisphosphonates Actonel Risedronate tablet Risedronate tablet Atelvia Risedronate DR tablet Risedronate DR tablet Boniva Ibandronate tablet Ibandronate tablet Fosamax Alendronate tablet Alendronate solution, tablet Fosamax Plus D Alendronate with Vitamin D tablet Non-Bisphosphonates Calcitonin-Salmon, Synthetic nasal spray Teriparatide pen injector Evista Raloxifene tablet Raloxifene tablet Forteo Teriparatide pen injector Tymlos Abaloparatide pen injector CONTRACEPTIVES Brand Name Generic Name Oral Desogestrel/Ethinyl Estradiol tablet Desogestrel-Ethinyl Estradiol/Ethinyl Estradiol tablet Drospirenone/Ethinyl Estradiol tablet Drospirenone/Ethinyl Estradiol/Levomethofolate tablet Ethynodiol/Ethinyl Estradiol tablet Levonorgestrel/Ethinyl Estradiol tablet Levonorgestrel/Ethinyl Estradiol/Ethinyl Estradiol tablet Norethindrone tablet Norethindrone/Ethinyl Estradiol tablet Norethindrone/Ethinyl Estradiol/Iron capsule, tablet, chewable tablet Norgestimate/Ethinyl Estradiol tablet Afirmelle Levonorgestrel/Ethinyl Estradiol tablet Altavera Levonorgestrel/Ethinyl Estradiol tablet Alyacen Norethindrone/Ethinyl Estradiol tablet Amethia/Amethia Lo Levonorgestrel/Ethinyl Estradiol/Ethinyl Estradiol tablet Amethyst Levonorgestrel/Ethinyl Estradiol tablet Apri Desogestrel/Ethinyl Estradiol tablet Aranelle Norethindrone/Ethinyl Estradiol tablet Ashlyna Levonorgestrel/Ethinyl Estradiol/Ethinyl Estradiol tablet Aubra/Aubra EQ Levonorgestrel/Ethinyl Estradiol tablet Aurovela/Aurovela Fe/Aurovela 24 Fe Norethindrone/Ethinyl Estradiol tablet Aviane Levonorgestrel/Ethinyl Estradiol tablet Ayuna Levonorgestrel/Ethinyl Estradiol tablet Azurette Desogestrel-Ethinyl Estradiol/Ethinyl Estradiol tablet Balcoltra Levonorgestrel/Ethinyl Estradiol/Iron tablet Balziva Norethindrone/Ethinyl Estradiol tablet Bekyree Desogestrel-Ethinyl Estradiol/Ethinyl Estradiol tablet Beyaz Dropirenone/Ethinyl Estradiol/Levonorgestrel tablet Blisovi Fe/Blisovi 24 Fe Norethindrone/Ethinyl Estradiol/Iron tablet Briellyn Norethindrone/Ethinyl Estradiol tablet Camila Norethindrone tablet Camrese/Camrese Lo Levonorgestrel/Ethinyl Estradiol/Ethinyl Estradiol tablet Caziant Desogestrel/Ethinyl Estradiol tablet Charlotte 24 Fe Norethindrone/Ethinyl Estradiol/Iron chewable tablet Chateal/Chateal EQ Levonorgestrel/Ethinyl Estradiol tablet Cryselle Norgestrel/Ethinyl Estradiol tablet Cyclafem Norethindrone/Ethinyl Estradiol tablet Cyred/Cyred EQ Desogestrel/Ethinyl Estradiol tablet Dasetta Norethindrone/Ethinyl Estradiol tablet Daysee Levonorgestrel/Ethinyl Estradiol/Ethinyl Estradiol tablet Deblitane Norethindrone tablet Dolishale Levonorgestrel/Ethinyl Estradiol tablet Elinest Norgestrel/Ethinyl Estradiol tablet Emoquette Desogestrel/Ethinyl Estradiol tablet Enpresse Levonorgestrel/Ethinyl Estradiol tablet Enskyce Desogestrel/Ethinyl Estradiol tablet Errin Norethindrone tablet Estarylla/Tri-Estarylla/Tri-Lo-Estarylla Norgestimate/Ethinyl Estradiol tablet Estrostep Fe Norethindrone/Ethinyl Estradiol/Iron tablet Falmina Levonorgestrel/Ethinyl Estradiol tablet Fayosim Levonorgestrel/Ethinyl Estradiol/Ethinyl Estradiol tablet Femynor/Tri Femynor Norgestimate/Ethinyl Estradiol tablet Gemmily Norethindrone/Ethinyl Estradiol/Iron capsule Generess Fe Norethindrone/Ethinyl Estradiol/Iron chewable tablet Gianvi Drospirenone/Ethinyl Estradiol tablet Hailey/Hailey 24 Fe/Hailey Fe Norethindrone/Ethinyl Estradiol/Iron tablet Heather Norethindrone tablet Iclevia Levonorgestrel/Ethinyl Estradiol tablet Incassia Norethindrone tablet Introvale Levonorgestrel/Ethinyl Estradiol tablet Isibloom Desogestrel/Ethinyl Estradiol