Step Two: Check the Preferred Drug List
The Preferred Drug List (PDL) is a subset of drugs listed in the formulary. Drugs are identified as preferred or non-preferred.
Preferred drugs
Preferred drugs are recommended by the Drug Utilization Review Board for their efficacy, clinical significance, cost effectiveness and safety. These drugs are available without prior authorization unless there is a separate clinical prior authorization requirement.
Non-preferred drugs
Non-preferred drugs require prior authorization. The prescriber or a representative must obtain approval before a pharmacy can dispense a non-preferred drug.
The PDL is updated in January and July each year. A drug’s status may change, so check back to determine whether a specific medication is preferred or non-preferred in the current PDL.
News You Can Use
Medicaid FFS and managed care use the PDL. CHIP does not have a PDL.