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LA Medicaid Preferred Drug List (PDL) Changes Effective January 1, 2025

Date: 12/26/24

On January 1, 2025 the Louisiana Medicaid Preferred Drug List (PDL) will be updated with recommendations from the October 2024 Medicaid Pharmaceutical and Therapeutics (P & T) Committee Meeting. 

Action Requested:

Louisiana Medicaid providers are advised to review their current patients receiving these medications that will be removed from the Preferred Drug List and will be non-preferred on the PDL.

Current prescribers of these medications for any Louisiana Healthcare Connections members were mailed a notification letter with patient information ahead of the change to allow for time and notice to get patients switched to a preferred alternative.

Additionally, we have notified affected patients of these changes in accordance with State requirements.

Medication Name

PDL Drug Class

CONDYLOX 0.5% GEL

Dermatology Immunomodulators, Topical

IBRANCE 100 MG CAPSULE

Oncology Oral – Breast

IBRANCE 125 MG TABLET

Oncology Oral – Breast

IBRANCE 75 MG TABLET

Oncology Oral – Breast

LAMOTRIGINE ODT 100 MG TABLET

Anticonvulsants

LAMOTRIGINE ODT 200 MG TABLET

Anticonvulsants

LAMOTRIGINE ODT 25 MG TABLET

Anticonvulsants

LAMOTRIGINE ODT 50 MG TABLET

Anticonvulsants

QUILLICHEW ER 20 MG CHEW TAB

ADD/ADHD Stimulants and Related Agents

QUILLICHEW ER 30 MG CHEW TAB

ADD/ADHD Stimulants and Related Agents

QUILLICHEW ER 40 MG CHEW TAB

ADD/ADHD Stimulants and Related Agents

The complete list of upcoming PDL changes are currently posted online by LDH for your reference.

We understand preferred alternative(s) may not be suitable for certain patients.  If you decide it makes sense to continue prescribing the non-preferred medication for this patient, please submit a prior authorization request with a supporting statement in one of the following ways:

If you have any questions, please call Provider Services at 1-800-424-1664.