Beta-Agonists, Inhaled Short-Acting
PDL Reference Documents
- Inhalers for Asthma and COPD - Jun 06, 2024
- Inhalers for Asthma and COPD - Feb 01, 2024
- Inhalers for Asthma/COPD - Dec 01, 2022
- Short-Acting Beta Agonists - Jul 25, 2019
- Asthma and COPD - Sep 24, 2015
- COPD/Asthma Class Update - Jul 31, 2014
- Asthma Rescue DERP Scan - Mar 27, 2014
- Asthma Rescue Scan Summary - Mar 27, 2014
Drug Use Review Documents
Newsletters
- March 2024 - Asthma Relief Inhaler Drug Use Evaluation
- August 2023 - 2023 Global Initiative for Chronic Obstructive Lung Disease Report: Focus on Revised Recommendations for Inhaler Products
- April 2022 - Asthma Guidance Update with a Focus on Changes for Managing Patients with Mild Asthma
- May 2017 - Updates in the Management of Chronic Obstructive Pulmonary Disease
PDL Status Values
Y = preferred
N = non-preferred. Non-preferred drugs listed as N but without clinical drug use criteria are subject to the
Non-Preferred Drugs in Select PDL Classes prior authorization criteria.
New drugs will be listed as N until reviewed by the P&T Committee and are subject to the
New Drug Policy.
V = voluntary non-preferred. Non-preferred mental health drugs are listed as V and prior authorization is not required.
Null (i.e. blank) = indicates the class or specific drug has not been reviewed for PDL placement.
To request a Prior Authorization, please use this form.
Generic Name | Brand Name | Form | PDL Status |
Current Drug Use Criteria | New Drug Evaluation |
---|---|---|---|---|---|
albuterol sulfate | VENTOLIN HFA | HFA AER AD | Y | ||
albuterol sulfate | ALBUTEROL SULFATE HFA | HFA AER AD | Y | ||
albuterol sulfate | ALBUTEROL SULFATE | VIAL-NEB | Y | ||
albuterol | ALBUTEROL | AER REFILL | N | ||
albuterol sulfate | PROAIR RESPICLICK | AER POW BA | N | ||
albuterol sulfate | PROAIR DIGIHALER | AER PW BAS | N | ||
levalbuterol HCl | LEVALBUTEROL CONCENTRATE | VIAL-NEB | N | ||
levalbuterol HCl | LEVALBUTEROL HCL | VIAL-NEB | N | ||
levalbuterol tartrate | XOPENEX HFA | HFA AER AD | N | ||
levalbuterol tartrate | LEVALBUTEROL TARTRATE HFA | HFA AER AD | N |