Preferred Drug List Changes
The following changes have been made to the Nebraska PDL. Changes are effective January 19, 2024.
| Nebraska PDL Therapeutic Drug Class | Brand Name (Route) | PDL Status before 01/19/2024 | PDL status on and after 01/19/2024 |
|---|---|---|---|
| ANTIHISTAMINES, MINIMALLY SEDATING | CETIRIZINE SOLUTION OTC (ORAL) | Non- Preferred | Preferred |
| ANTIHISTAMINES, MINIMALLY SEDATING | CETIRIZINE SOLUTION (ORAL) | Preferred | Non-Preferred |
| ANTIHYPERURICEMICS | COLCHICINE TABLET (AG) (ORAL) | Non- Preferred | Preferred |
| ANTIHYPERURICEMICS | COLCHICINE TABLET (ORAL) | Non- Preferred | Preferred |
| ANTIHYPERURICEMICS | MITIGARE (ORAL) | Preferred | Non-Preferred |
| BRONCHODILATORS, BETA AGONIST | ALBUTEROL HFA (PROVENTIL) (AG) (INHALATION) | Non- Preferred | Preferred |
| BRONCHODILATORS, BETA AGONIST | ALBUTEROL HFA (PROVENTIL) (INHALATION) | Non- Preferred | Preferred |
| BRONCHODILATORS, BETA AGONIST | XOPENEX HFA (INHALATION) | Non- Preferred | Preferred |
| COLONY STIMULATING FACTORS | FYLNETRA (SUBCUTANEOUS) | Non- Preferred | Preferred |
| COLONY STIMULATING FACTORS | NEUPOGEN DISP SYRIN (INJECTION) | Non- Preferred | Preferred |
| COLONY STIMULATING FACTORS | NYVEPRIA (SUBCUTANEOUS) | Preferred | Non-Preferred |
| COPD AGENTS | ROFLUMILAST (ORAL) | Non- Preferred | Preferred |
| EPINEPHRINE, SELF-INJECTED | AUVI-Q 0.1 MG (INTRAMUSC) | Non- Preferred | Preferred |
| ERYTHROPOIESIS STIMULATING PROTEINS | ARANESP DISP SYRIN (INJECTION) | Non- Preferred | Preferred |
| ERYTHROPOIESIS STIMULATING PROTEINS | ARANESP VIAL (INJECTION) | Non- Preferred | Preferred |
| ERYTHROPOIESIS STIMULATING PROTEINS | RETACRIT (VIFOR) (INJECTION) | Preferred | Non-Preferred |
| GLUCOCORTICOIDS, INHALED | ARNUITY ELLIPTA (INHALATION) | Non- Preferred | Preferred |
| GLUCOCORTICOIDS, INHALED | TRELEGY ELLIPTA (INHALATION) | Non- Preferred | Preferred |
| GLUCOCORTICOIDS, INHALED | ASMANEX HFA (INHALATION) | Non- Preferred | Preferred |
| HEMOPHILIA TREATMENT | KOVALTRY (INTRAVEN.) | Non- Preferred | Preferred |
| IDIOPATHIC PULMONARY FIBROSIS | PIRFENIDONE CAPSULE (ESBRIET) (ORAL) | Non- Preferred | Preferred |
| IDIOPATHIC PULMONARY FIBROSIS | PIRFENIDONE TABLET (ESBRIET) (ORAL) | Non- Preferred | Preferred |
| IMMUNOMODULATORS, ATOPIC DERMATITIS | ADBRY (SUBCUTANEOUS) | Non- Preferred | Preferred |
| IMMUNOMODULATORS, ATOPIC DERMATITIS | TACROLIMUS (AG) (TOPICAL) | Non- Preferred | Preferred |
| IMMUNOMODULATORS, ATOPIC DERMATITIS | TACROLIMUS (TOPICAL) | Non- Preferred | Preferred |
| IMMUNOMODULATORS, ATOPIC DERMATITIS | PROTOPIC (TOPICAL) | Preferred | Non-Preferred |
| MOVEMENT DISORDERS | AUSTEDO XR (ORAL) | Non- Preferred | Preferred |
| MOVEMENT DISORDERS | AUSTEDO XR TITR PK (ORAL) | Non- Preferred | Preferred |
| NSAIDS | PENNSAID PUMP (TOPICAL) | Non- Preferred | Preferred |
| NSAIDS | DICLOFENAC SODIUM PUMP (AG) (TOPICAL) | Preferred | Non-Preferred |
| NSAIDS | DICLOFENAC SODIUM PUMP (TOPICAL) | Preferred | Non-Preferred |
| ONCOLOGY, ORAL - HEMATOLOGIC | MELPHALAN (ORAL) | Non- Preferred | Preferred |
| ONCOLOGY, ORAL - LUNG | ERLOTINIB (ORAL) | Non- Preferred | Preferred |
| ONCOLOGY, ORAL - PROSTATE | XTANDI CAPSULE (ORAL) | Non- Preferred | Preferred |
| ONCOLOGY, ORAL - PROSTATE | XTANDI TABLET (ORAL) | Non- Preferred | Preferred |
| ONCOLOGY, ORAL - RENAL CELL | VOTRIENT (ORAL) | Non- Preferred | Preferred |
| OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS | TOBRAMYCIN / DEXAMETHASONE SUSPENSION (OPHTHALMIC) | Non- Preferred | Preferred |
| OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS | OLOPATADINE OTC (PATADAY TWICE A DAY) (OPHTHALMIC) | Non- Preferred | Preferred |
| OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS | OLOPATADINE (PATANOL) (OPHTHALMIC) | Preferred | Non-Preferred |
| OTIC ANTIBIOTICS | CIPROFLOXACIN/DEXAMETHASONE (AG) (OTIC) | Non- Preferred | Preferred |
| OTIC ANTIBIOTICS | CIPROFLOXACIN/DEXAMETHASONE (OTIC) | Non- Preferred | Preferred |
| STIMULANTS AND RELATED AGENTS | DAYTRANA (TRANSDERMAL) | Non- Preferred | Preferred |
| STIMULANTS AND RELATED AGENTS | DYANAVEL XR (ORAL) | Non- Preferred | Preferred |
| STIMULANTS AND RELATED AGENTS | DYANAVEL XR TABLET (ORAL) | Non- Preferred | Preferred |
| STIMULANTS AND RELATED AGENTS | QUILLIVANT XR (ORAL) | Non- Preferred | Preferred |