Corticosteroids/Beta-Agonist Combination, Inhaled
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
- Asthma and COPD maintenance medications - Oct 01, 2020
- Asthma and COPD Maintenance Medications - May 23, 2019
- Class Scan: Asthma and COPD - Jan 25, 2018
- Drugs to Treat Asthma and Chronic Obstructive Pulmonary Disease (COPD) - Sep 29, 2016
- Asthma and COPD - Sep 24, 2015
- COPD/Asthma Class Update - Jul 31, 2014
- COPD Class Update and Breo Ellipta New Drug Evaluation - Nov 21, 2013
- Class Scan: COPD Medications - Sep 26, 2013
- Drug Class Review: Controller Medications for Asthma - Jul 25, 2013
- Class Update: Asthma Controllers - May 31, 2012
- Abbreviated Class Review: COPD - Feb 23, 2012
Drug Use Review Documents
Newsletters
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 |
---|---|---|---|---|---|
budesonide/formoterol fumarate | SYMBICORT | HFA AER AD | Y | ||
budesonide/formoterol fumarate | BUDESONIDE-FORMOTEROL FUMARATE | HFA AER AD | Y | ||
budesonide/formoterol fumarate | BREYNA | HFA AER AD | Y | ||
fluticasone propion/salmeterol | AIRDUO RESPICLICK | AER POW BA | Y | ||
fluticasone propion/salmeterol | FLUTICASONE-SALMETEROL | AER POW BA | Y | ||
fluticasone propion/salmeterol | WIXELA INHUB | BLST W/DEV | Y | ||
fluticasone propion/salmeterol | ADVAIR DISKUS | BLST W/DEV | Y | ||
fluticasone propion/salmeterol | FLUTICASONE-SALMETEROL | BLST W/DEV | Y | ||
fluticasone propion/salmeterol | FLUTICASONE-SALMETEROL HFA | HFA AER AD | Y | ||
fluticasone propion/salmeterol | ADVAIR HFA | HFA AER AD | Y | ||
mometasone/formoterol | DULERA | HFA AER AD | Y | ||
albuterol sulfate/budesonide | AIRSUPRA | HFA AER AD | N | ||
fluticasone propion/salmeterol | AIRDUO DIGIHALER | AER PW BAS | N | ||
fluticasone/vilanterol | FLUTICASONE-VILANTEROL | BLST W/DEV | N | ||
fluticasone/vilanterol | BREO ELLIPTA | BLST W/DEV | N |