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PDL Options

Prescription Drug Lists

Advantage PDL

Fresh Start Advantage Prescription Drug List (pdf)

The Advantage PDL is flexible – with an "any drug, any tier" approach the medication that represents the best health care value will always be the most affordable – no matter if it's a brand name drug or a generic.

The Advantage PDL is also responsive – it quickly responds to market changes, new clinical information and cost shifts and moves medications to higher tiers twice a year.

The Advantage PDL guides members to the highest value, lowest cost medications.

Traditional PDL

Fresh Start Traditional Prescription Drug List (pdf)

The Traditional PDL is a more traditional drug list that has less member impact – however it does not offer the same level of cost savings as the Advantage PDL. Drugs move to a higher tier only once a year – on January 1. Generics (or their brand therapeutic equivalents) are always in Tier 1, the lowest copayment level. For some classes where there are no generics, we place select brands in Tier 1.

We have implemented the same programs on the Traditional PDL as the Advantage PDL – this makes it as effective as possible in helping members make the most of their pharmacy benefit.

Comparing Advantage vs. Traditional PDL

Two PDL strategies provide greater flexibility to meet your needs.

  • The Advantage PDL offers increased value and savings by guiding members to the highest value medications.
  • The Traditional PDL offers conventional, less aggressive options.

1. Generics are primarily placed in Tier 1 on the Traditional PDL, however, there are situations where the chemical equivalent of the generic is in Tier 1 instead.

Watch This!

Prescription Drug List Management