Pennsylvania Medical Assistance (MA) Programs Preferred Drug List (PDL) and Pharmacy and Therapeutics (P and T) Committee Information Page

Effective January 1, 2020, the PDL is utilized by the Fee-for-Service (FFS) program and all MA managed care organizations (MCOs) that provide outpatient drug services to MA beneficiaries in Pennsylvania. The Department of Human Services’ (Department) Pharmacy & Therapeutics (P&T) Committee (“the committee”) developed and maintains the PDL. The committee evaluates all drugs on the PDL based on clinical effectiveness, safety, outcomes, and, if drugs are clinically equivalent, cost. The committee designates the drugs that are determined to be best in a therapeutic class as preferred on the PDL. All MA covered drugs designated as non-preferred are covered and available to MA beneficiaries when found to be medically necessary through the prior authorization process. The FFS program and the MA MCOs use the same prior authorization guidelines to determine medical necessity.

More information on the Pennsylvania Department of Human Services Pharmacy & Therapeutics Committee is available at this page.