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