This is the list of preferred brands. Using a generic drug requires prior authorization (PA)
July 11, 2018
| Preferred Brand | Generic Requires Prior Authorization |
| ADDERALL XR | AMPHETAMINE SALT COMBO ER |
| AGGRENOX | ASPIRIN/DIPYRIDAMOLE |
| ALDARA | IMIQUIMOD 5% CREAM |
| ANDROGEL GEL PACKET | TESTOSTERONE GEL PACKET |
| ANDROGEL GEL PUMP | TESTOSTERONE GEL PUMP |
| BENZACLIN | CLINDAMYCIN / BENZOYL PEROXIDE |
| COPAXONE 20 MG/ML | GLATOPA 20 MG/ML; GLATIRAMER 20 MG/ML |
| DIASTAT | DIAZEPAM RECTAL |
| DIFFERIN 0.1% and 0.3% (GEL AND CREAM) | ADAPALAENE 0.1% and 0.3% (GEL AND CREAM) |
| DIFFERIN GEL PUMP | ADAPALENE GEL PUMP |
| DUETACT | PIOGLITAZONE/GLIMEPIRIDE |
| GABITRIL | TIAGABINE |
| FOCALIN XR | DEXMETHYLPHENIDATE XR |
| GLEEVEC | IMATINIB |
| KITABIS (INHALATION) | TOBRAMYCIN (INHALATION) |
| LESCOL XL | FLUVASTATIN ER |
| METADATE CD | METHYLPHENIDATE CD |
| NIASPAN | NIACIN ER |
| PATADAY (OPHTHALMIC) | OLOPATADINE DROPS |
| PATANASE (NASAL) | OLOPATADINE (NASAL) |
| PATANOL (OPHTHALMIC) | OLOPATADINE 0.1% |
| PROTOPIC | TACROLIMUS OINTMENT |
| PROVIGIL | MODAFINIL |
| PULMICORT INHALATION SOLUTION | BUDESONIDE INHLATION SOLUTION |
| RELPAX | ELETRIPTAN |
| RENVELA | SEVELAMER CARBONATE |
| RITALIN LA | METHYLPHENIDATE ER |
| STRATTERA | ATOMOXETINE |
| SUPRAX SUSPENSION | CEFIXIME SUSPENSION |
| TOBRADEX SUSPENSION (OPHTHALMIC) | TOBRAMYCIN / DEXAMETHASONE SUSPENSION (OPHTHALMIC) |
| TRICOR | FENOFIBRATE TABLET |
| TRILIPIX | FENOFIBRIC ACID |
| VYTORIN | EZETIMIBE-SIMVASTATIN |
| ZETIA | EZETIMIBE |
