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North Carolina Medicaid’s Preferred Drug List November 2012 Updates

North Carolina Medicaid’s Preferred Drug List November 2012 Updates

  • is a searchable PDF; just right click, select find & type med name.
  • is not a formulary, so meds NOT listed may still be covered.
  • criteria for a non-preferred medication is trial & failure of 2 preferred meds, excluding allergies or contraindications.
  • Some brands may be preferred but the pharmacist can substitute the generic or brand at time of dispensing without prescriber input (rare exclusions exist)
  • Some meds maybe preferred but still need a PA if there are step criteria (losartan requires ACEI as first step) or quantity limits(hypnotics max 15 doses/month, migraine agents max).
  • Pulmicort became preferred over its generic budesonide on 11/14but a Pulmicort shortage resulted in pharmacies erroneously faxing prior auth requests to providers for budesonide; the pharmacies are supposed to call ACS and get a 1 month approval to fill the Rx with the budesonide until the brand is available. QVAR remains preferred
  • Confused yet? Hey, we are just the messengers.

Quick summary of NC Medicaid’s 11/14/12 PDL changes

(non-preferred, new additions to preferred status)

PPIs: Nexium; omeprazole, pantoprazole and lansoprazole
Quinolones: Avelox, levofloxacin, ciprofloxacin
Statins: Crestor, atorvastatin, simvastatin, lovastatin, pravastatin
BPH: Alfuzosin, Avodart, Cardura/Cardura XL, Flomax, Jalyn, Rapaflo; Cialis, doxazosin, finasteride, Proscar, tamsulosin, terazosin, Uroxatral
Anticoagulants: warfarin, Pradaxa, Xarelto
Skeletal muscle relaxants: carisoprodol, orphenadrine, dantrolene, cyclobenzaprine, tizanidine tabs, methocarbamol, baclofen,
Short –Acting ?-agonists: Pro-air HFA (dose counter expected 12/12-cool!); Ventolin will be non-preferred 4/1/13 –be sure you
select Pro-Air in EPIC or your eprescribe software starting 4/1/13!
Anti-Arrhythmics: <strike>Multaq, Norpace,Tikosyn, Pacerone, Rythmol SR</strike>, Tambocor & generic anti-arrhythmics
COPD agents: Ipratroprium-albuterol (generic Duoneb). Failure of 1 preferred agent is required to obtain Daliresp