September 9, 2020
- Tables below updated Sept. 9 to correct non preferred status for Novolin flexpen.
VDP temporarily removed the non-preferred status on April 1 in response to reported drug shortages for insulin products in the "Hypoglycemics, Insulins" drug class. VDP will reverse this change in status because of sufficient availability in the market. VDP made this determination after verifying the current availability of the preferred insulin products, as well as the non-preferred insulin products through multiple sources such as ASHP, FDA, manufacturers, wholesalers, and pharmacies in various regions around Texas.
Beginning Sept. 18, the formulary will reflect the PDL status changes for all non-preferred insulin products. VDP will restore the non-preferred status on the following drugs because of sufficient product availability:
| NDC | Drug Name |
| 00024592410 | ADMELOG 100 UNIT/ML VIAL |
| 00024592605 | ADMELOG 100 UNIT/ML VIAL |
| 00024592505 | ADMELOG SOLOSTAR 100 UNIT/ML |
| 47918089190 | AFREZZA 12 UNIT CARTRIDGE |
| 47918087490 | AFREZZA 4 UNIT CARTRIDGE |
| 47918090218 | AFREZZA 4 UNIT/8 UNIT/12 UNIT |
| 47918087890 | AFREZZA 8 UNIT CARTRIDGE |
| 47918088018 | AFREZZA 90-4 UNIT / 90-8 UNIT |
| 00088250033 | APIDRA 100 UNITS/ML VIAL |
| 00088250205 | APIDRA SOLOSTAR 100 UNITS/ML |
| 00002771559 | BASAGLAR 100 UNIT/ML KWIKPEN |
| 00169320415 | FIASP 100 UNIT/ML FLEXTOUCH |
| 00169320111 | FIASP 100 UNIT/ML VIAL |
| 00169320515 | FIASP PENFILL 100 UNIT/ML CART |
| 00002771227 | HUMALOG 200 UNIT/ML KWIKPEN |
| 66733082259 | INSULIN LISPRO 100 UNIT/ML PEN |
| 66733077301 | INSULIN LISPRO 100 UNIT/ML VL |
| 00169183711 | NOVOLIN 70-30 100 UNIT/ML VIAL |
| 00169300715 | NOVOLIN 70-30 FLEXPEN |
| 00169300415 | NOVOLIN N 100 UNIT/ML FLEXPEN |
| 00169300315 | NOVOLIN R 100 UNIT/ML FLEXPEN |
| 00024587102 | TOUJEO MAX SOLOSTR 300 UNIT/ML |
| 00024586903 | TOUJEO SOLOSTAR 300 UNIT/ML |
| 00169266211 | TRESIBA 100 UNIT/ML VIAL |
| 00169266015 | TRESIBA FLEXTOUCH 100 UNIT/ML |
| 00169255013 | TRESIBA FLEXTOUCH 200 UNIT/ML |
The preferred PDL options are:
| NDC | Drug Name |
| 00002751001 | HUMALOG 100 UNIT/ML VIAL |
| 00002751659 | HUMALOG 100 UNIT/ML CARTRIDGE |
| 00002879959 | HUMALOG 100 UNIT/ML KWIKPEN |
| 00002751017 | HUMALOG 100 UNIT/ML VIAL |
| 00002771459 | HUMALOG JR 100 UNIT/ML KWIKPEN |
| 00002879859 | HUMALOG MIX 50-50 KWIKPEN |
| 00002751201 | HUMALOG MIX 50-50 VIAL |
| 00002879759 | HUMALOG MIX 75-25 KWIKPEN |
| 00002751101 | HUMALOG MIX 75-25 VIAL |
| 00002880359 | HUMULIN 70/30 KWIKPEN |
| 00002871501 | HUMULIN 70-30 VIAL |
| 00002871517 | HUMULIN 70-30 VIAL |
| 00002880559 | HUMULIN N 100 UNIT/ML KWIKPEN |
| 00002831501 | HUMULIN N 100 UNIT/ML VIAL |
| 00002831517 | HUMULIN N 100 UNIT/ML VIAL |
| 00002821501 | HUMULIN R 100 UNIT/ML VIAL |
| 00002821517 | HUMULIN R 100 UNIT/ML VIAL |
| 00002882427 | HUMULIN R 500 UNIT/ML KWIKPEN |
| 00002850101 | HUMULIN R 500 UNIT/ML VIAL |
| 00088222033 | LANTUS 100 UNIT/ML VIAL |
| 00088502101 | LANTUS 100 UNIT/ML VIAL |
| 00088221905 | LANTUS SOLOSTAR 100 UNIT/ML |
| 00088502005 | LANTUS SOLOSTAR 100 UNIT/ML |
| 00169368712 | LEVEMIR 100 UNIT/ML VIAL |
| 00169643810 | LEVEMIR FLEXTOUCH 100 UNIT/ML |
| 00169183411 | NOVOLIN N 100 UNIT/ML VIAL |
| 00169183311 | NOVOLIN R 100 UNIT/ML VIAL |
| 00169330312 | NOVOLOG 100 UNIT/ML CARTRIDGE |
| 00169633910 | NOVOLOG 100 UNIT/ML FLEXPEN |
| 00169750111 | NOVOLOG 100 UNIT/ML VIAL |
| 00169369619 | NOVOLOG MIX 70-30 FLEXPEN |
| 00169368512 | NOVOLOG MIX 70-30 VIAL |
Tags:
PDL