Statewide Preferred Drug List Information
The Department of Human Services ("the Department") maintains a Statewide Preferred Drug List (PDL) to ensure that Medical Assistance (MA) program beneficiaries in the Fee-for-Service (FFS) and Managed Care Organization (HealthChoices, Community Health Choices) delivery systems have access to clinically effective pharmaceutical care with an emphasis on quality, patient safety, and optimal results from the drugs that are prescribed for them.
When considering medications for MA beneficiaries, providers should try to utilize drugs that are designated as preferred on the Statewide PDL. Drugs designated as non-preferred on the PDL remain available to MA beneficiaries when determined to be medically necessary through the prior authorization process.
The drugs that are designated as preferred on the Statewide PDL are those that are determined by the Department's Pharmacy & Therapeutics (P&T) Committee to be the best in a particular class based on effectiveness, safety, and clinical outcomes. When all drugs in a class are clinically equivalent, the cost of the drug including rebates will be considered. Some preferred drugs require clinical prior authorization to ensure appropriate use and patient safety. Please refer to Pharmacy Prior Authorization General Information and Pharmacy Prior Authorization Clinical Guidelines for additional information.
Non-preferred drugs remain available to MA beneficiaries when found to be medically necessary. All drugs designated as non-preferred require prior authorization before the prescriptions may be dispensed at the pharmacy. Refer to the Pharmacy Prior Authorization Clinical Guidelines relating to the corresponding PDL class of drugs.
The Department contracts with Change Healthcare to provide consultation and support for the Statewide PDL.
The latest version of the PDL can be found on the Change Healthcare website.