draft essential diabetes drug list - dhhs...
TRANSCRIPT
Helping People. It’s who we are and what we do.
DRAFT Essential Diabetes
Drug List
Draft Report Date:
January 14, 2019
Richard Whitley, MS
Director
Steve Sisolak
Governor
Prepared by: Primary Care and Health Workforce Development Office, State of Nevada
Division of Public and Behavioral Health (DPBH) 4150 Technology Way, Suite 300 Carson City, NV 89706
Office: (775) 684-4255 Email: [email protected] drugtransparency.nv.gov
Julie Kotchevar, PhD
DPBH Administrator
DRAFT
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Helping People. It’s who we are and what we do.
Introduction
During the 79th legislative session, Senate Bill (SB) 539, which supports prescription drug transparency, was approved. SB 539 was codified in Nevada Revised Statute (NRS) 439B. The law requires in NRS 439B.630 that the Department of Health and Hu-man Services (DHHS) compile a list of prescription drugs essential for treating diabetes in Ne-vada:
NRS 439B.630 Department to annually compile lists of certain prescription drugs essential for treating diabetes. On or before February 1 of each year, the De-partment shall compile:
1. A list of prescription drugs that the Department determines to be essential for treat-ing diabetes in this State and the wholesale acquisition cost of each such drug on the list. The list must include, without limitation, all forms of insulin and biguanides mar-keted for sale in this State.
2. A list of prescription drugs described in subsection 1 that have been subject to an increase in the wholesale acquisition cost of a percentage equal to or greater than:
a.) The percentage increase in the Consumer Price Index, Medical Care Compo-nent during the immediately preceding calendar year; or
b.) Twice the percentage increase in the Consumer Price Index, Medical Care Component during the immediately preceding 2 calendar years.
(Added to NRS by 2017, 4297)
The first essential diabetes drug list was published on October 31, 2017. The list published in this report provides a draft version of the 2019 Essential Diabetes Drug List. The public and other stakeholders can request updates to this draft list by 7PM Pacific Standard Time on Wednesday, January 23, 2019 using the email address [email protected]. All re-quests will be carefully reviewed before updating and posting the final list online by the re-quired deadline of February 1, 2019. This final list will include the price increase data required by NRS 439B.630, Section 2. Manufacturers that produce drugs found on this list are required to submit reports by April 1, 2019 that include information about these drugs as outlined in NRS 439B.635 and NRS 439B.640. Additionally, Pharmacy Benefit Manager (PBMs) are re-quired to provide information to DHHS by April 1, 2019 regarding these drugs as outlined in NRS 439B.645.
Report Methodology
To compile the draft DHHS essential diabetes drug list, DHHS utilized a methodology that met the requirements of NRS 439B.630. Two versions of the list are published: (1) a summary of the nonproprietary and brand or proprietary drug names found on the essential list [Appendix 1], and (2) a detailed list of all the drug National Drug Codes (NDCs) indicated by DHHS as essen-tial diabetes drugs [Appendix 2]. The summary list (Appendix 1) is conveniently formatted for the public and health care providers while the NDC list (Appendix 2) is designed for drug man-ufacturers and PBMs to know which specific drug NDCs will be monitored by DHHS and includ-ed on its yearly report.
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Helping People. It’s who we are and what we do.
To generate the list, DHHS identified NDCs that included varying drug packing formula-tions based on prior and current stakeholder input of essential diabetes drugs. These NDC codes were filtered down to include the drugs for which Medicaid expended funds in the past two years. Additional NDCs that were of interest to the public and stakehold-ers were added to this list.
This essential list does not include any drugs used to treat co-morbidities often present in an in-dividual with diabetes. The list does not contain every single drug that may be an effective treat-ment for diabetes or approved for the treatment of diabetes. This list attempts to refine the nu-merous treatments to those approved for treatment, identified by prescribers as essential, and most frequently prescribed in Nevada (as determined by the publicly available data sources). For this reason, some brand names are excluded when generics or alternative brands are includ-ed.
DHHS invites you to view the Drug Transparency website at drugtransparency.nv.gov. If you are interested in receiving email notifications for Nevada Drug Transparency information and up-dates, please subscribe online to the DHHS Drug Transparency LISTSERV.
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Helping People. It’s who we are and what we do.
Appendix 1:
2019 Draft DHHS Essential Diabetes
Drugs Summary List
DRAFT
Appendix 1: Essential Diabetes Drugs Summary List
Page 1 of 2
Essential Non-Propietary Drug NameIncluded Essential Drug Brand Names
(Note: some brand names are excluded from this list)
Pioglitazone and Metformin HCL Actoplus Met; Actoplus Met XR
Pioglitazone Actos
Lixisenatide Adlyxin
Insulin Lispro
Admelog; Humalog; Humalog 50-50; Humalog 75-25;
Humalog Jr
Insulin Human
Afrezza; Humulin; Humulin N; Humulin R; Humulin R500;
Novolin R; Novolin N; Novolin 70/30
Glimepiride Amaryl
Insulin Glulisine Apidra
Rosiglitazone Avandia
Insulin Glargine Basaglar; Lantus; Toujeo
Exenatide Bydureon; Bydureon BCise; Byetta
Bromocriptine Mesylate Cycloset
Dapagliflozin Farxiga
Insulin Aspart Fiasp; Novolog; Novolog 70/30
Metformin HCL
Fortamet ER; Glumetza ER; Glucophage; Glucophage XR;
Riomet; Metformin ER
Glipizide Glucotrol; Glucotrol XL; Glipizide XL; Glipizide ER
Glyburide Glynase
Miglitol Glyset
Empagliflozin and Linagliptin Glyxambi
Canagliflozin and Metformin HCL Invokamet; Invokamet XR
Canagliflozin Invokana
Sitagliptin and Metformin HCL Janumet; Janumet XR
Sitagliptin Januvia
Empagliflozin Jardiance
Linagliptin and Metformin HCL Jentadueto; Jentadueto XR
Alogliptin and Metformin HCL Kazano
Saxagliptin and Metformin HCL Kombiglyze XR
Insulin Detemir Levemir
Alogliptin Nesina
Saxagliptin Onglyza
Alogliptin and Pioglitazone Oseni
Semaglutide Ozempic
Repaglinide Prandin
Ertugliflozin and Metformin HCL Segluromet
Insulin Glargine and Lixisenatide Soliqua 100/33
Nateglinide Starlix
Ertugliflozin Steglatro
Ertugliflozin and Sitagliptin Steglujan
Pramlintide Acetate SymlinPen
Empagliflozin and Metformin HCL Synjardy; Synjardy XR
Albiglutide Tanzeum
Linagliptin Tradjenta
DRAFT
Appendix 1: Essential Diabetes Drugs Summary List
Page 2 of 2
Essential Non-Propietary Drug NameIncluded Essential Drug Brand Names
(Note: some brand names are excluded from this list)
Insulin Degludec Tresiba
Dulaglutide Trulicity
Liraglutide Victoza
Colesevelam HCL Welchol
Dapagliflozin and Metformin HCL Xigduo XR
Insulin Degludec and Liraglutide Xultophy 100/3.6
Acarbose
Glipizide and Metformin HCL
Glyburide and Metformin HCL
Pioglitazone and Glimepiride
DRAFT
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Helping People. It’s who we are and what we do.
Appendix 2:
2019 Draft DHHS Essential Diabetes Drug
NDC List
DRAFT
Appendix 2: Essential Diabetes Drugs NDC List
Page 1 of 16
NDC Essential Diabetes Drug Name
47781-0342-01 Acarbose
00054-0142-25 Acarbose
64380-0760-06 Acarbose
69543-0122-10 Acarbose
23155-0149-01 Acarbose
00115-1152-02 Acarbose
00054-0140-25 Acarbose
64380-0758-06 Acarbose
16252-0523-01 Acarbose
69543-0120-10 Acarbose
47781-0340-01 Acarbose
00054-0141-25 Acarbose
00378-2821-77 Acarbose
47781-0341-01 Acarbose
69543-0121-10 Acarbose
64380-0759-06 Acarbose
64764-0158-60 Actoplus Met
64764-0510-30 Actoplus Met XR
64764-0310-30 Actoplus Met XR
64764-0151-05 Actos
64764-0151-04 Actos
64764-0301-15 Actos
64764-0301-14 Actos
64764-0451-24 Actos
64764-0451-25 Actos
00024-5745-02 Adlyxin
00024-5747-02 Adlyxin
00024-5924-10 Admelog
47918-0891-90 Afrezza
47918-0882-36 Afrezza
47918-0874-90 Afrezza
47918-0902-18 Afrezza
47918-0884-63 Afrezza
47918-0894-63 Afrezza
47918-0880-18 Afrezza
47918-0878-90 Afrezza
45802-0211-72 Alogliptin-Metformin
45802-0169-72 Alogliptin-Metformin
00039-0221-10 Amaryl
00088-2500-33 Apidra
00088-2502-05 Apidra
00173-0861-18 Avandia
00002-7715-01 Basaglar
00002-7715-59 Basaglar
00574-0106-01 Bromocriptine
00781-5325-31 Bromocriptine
DRAFT
Appendix 2: Essential Diabetes Drugs NDC List
Page 2 of 16
NDC Essential Diabetes Drug Name
00781-5325-01 Bromocriptine
63304-0962-30 Bromocriptine
00574-0106-03 Bromocriptine
00378-2042-01 Bromocriptine
00378-7096-01 Bromocriptine
00378-7096-93 Bromocriptine
60687-0286-21 Bromocriptine
68382-0110-06 Bromocriptine
00310-6530-04 Bydureon
00310-6520-04 Bydureon
00310-6540-04 Bydureon BCise
00310-6524-01 Byetta
00310-6512-01 Byetta
51660-0996-28 Colesevelam
68012-0258-20 Cycloset
00310-6210-30 Farxiga
00003-1428-11 Farxiga
00310-6205-30 Farxiga
00169-3204-15 Fiasp
00169-3201-11 Fiasp
59630-0575-60 Fortamet ER
59630-0574-60 Fortamet ER
55111-0320-05 Glimepiride
55111-0320-01 Glimepiride
68001-0177-00 Glimepiride
54458-0968-10 Glimepiride
61442-0115-01 Glimepiride
16729-0001-16 Glimepiride
16729-0001-01 Glimepiride
69452-0128-20 Glimepiride
00093-7254-01 Glimepiride
69452-0128-30 Glimepiride
69543-0123-50 Glimepiride
69543-0123-10 Glimepiride
61442-0116-01 Glimepiride
54458-0967-16 Glimepiride
00093-7255-01 Glimepiride
55111-0321-01 Glimepiride
55111-0321-05 Glimepiride
00378-4012-01 Glimepiride
54458-0967-10 Glimepiride
69452-0129-20 Glimepiride
69543-0124-10 Glimepiride
16729-0002-01 Glimepiride
16729-0002-16 Glimepiride
69543-0124-50 Glimepiride
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Appendix 2: Essential Diabetes Drugs NDC List
Page 3 of 16
NDC Essential Diabetes Drug Name
68001-0178-00 Glimepiride
68645-0572-90 Glimepiride
61442-0116-05 Glimepiride
68001-0178-03 Glimepiride
69452-0130-30 Glimepiride
61442-0117-05 Glimepiride
55111-0322-01 Glimepiride
69452-0130-20 Glimepiride
61442-0117-01 Glimepiride
68645-0573-90 Glimepiride
69543-0125-10 Glimepiride
55111-0322-05 Glimepiride
68001-0179-03 Glimepiride
51079-0426-20 Glimepiride
00093-7256-01 Glimepiride
00093-7256-52 Glimepiride
68001-0179-00 Glimepiride
00378-4013-01 Glimepiride
16729-0003-01 Glimepiride
16729-0003-16 Glimepiride
54458-0966-10 Glimepiride
69543-0125-50 Glimepiride
54458-0966-16 Glimepiride
60505-0142-02 Glipizide
16729-0140-16 Glipizide
16729-0140-00 Glipizide
00781-1453-10 Glipizide
00781-1453-01 Glipizide
00591-0461-10 Glipizide
60505-0142-04 Glipizide
60505-0142-01 Glipizide
60505-0142-00 Glipizide
00591-0461-01 Glipizide
00378-1110-05 Glipizide
00378-1110-01 Glipizide
51079-0811-20 Glipizide
00591-0461-05 Glipizide
68645-0151-59 Glipizide
00591-0460-05 Glipizide
00781-1452-01 Glipizide
00781-1452-10 Glipizide
68645-0150-54 Glipizide
57664-0398-13 Glipizide
00591-0460-10 Glipizide
16729-0139-16 Glipizide
00591-0460-01 Glipizide
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Appendix 2: Essential Diabetes Drugs NDC List
Page 4 of 16
NDC Essential Diabetes Drug Name
00378-1105-05 Glipizide
00378-1105-01 Glipizide
51079-0810-20 Glipizide
60505-0141-02 Glipizide
60505-0141-01 Glipizide
60505-0141-00 Glipizide
16729-0139-00 Glipizide
10370-0746-05 Glipizide ER
10370-0746-01 Glipizide ER
10370-0191-05 Glipizide ER
10370-0191-01 Glipizide ER
00591-0845-10 Glipizide ER
00591-0845-01 Glipizide ER
00378-0431-01 Glipizide ER
00591-0845-15 Glipizide ER
64980-0281-01 Glipizide ER
64980-0281-05 Glipizide ER
68084-0295-21 Glipizide ER
00378-0340-93 Glipizide ER
64980-0279-03 Glipizide ER
00591-0900-30 Glipizide ER
10370-0745-05 Glipizide ER
00378-0342-01 Glipizide ER
68084-0111-01 Glipizide ER
00591-0844-10 Glipizide ER
10370-0745-01 Glipizide ER
00591-0844-15 Glipizide ER
10370-0190-05 Glipizide ER
10370-0190-01 Glipizide ER
00591-0844-01 Glipizide ER
64980-0280-05 Glipizide ER
64980-0280-01 Glipizide ER
68084-0112-01 Glipizide ER
59762-0542-02 Glipizide XL
59762-0542-01 Glipizide XL
59762-0540-01 Glipizide XL
59762-0541-02 Glipizide XL
59762-0541-01 Glipizide XL
00093-7455-01 Glipizide-Metformin
00093-7456-01 Glipizide-Metformin
23155-0116-01 Glipizide-Metformin
00378-3132-01 Glipizide-Metformin
68382-0185-01 Glipizide-Metformin
00378-3133-01 Glipizide-Metformin
23155-0117-01 Glipizide-Metformin
00093-7457-01 Glipizide-Metformin
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Appendix 2: Essential Diabetes Drugs NDC List
Page 5 of 16
NDC Essential Diabetes Drug Name
68382-0186-01 Glipizide-Metformin
00087-6071-11 Glucophage
00087-6060-05 Glucophage
00087-6064-13 Glucophage XR
00049-4120-66 Glucotrol
00049-4110-66 Glucotrol
00049-0174-02 Glucotrol XL
00049-0178-08 Glucotrol XL
00049-0178-07 Glucotrol XL
00049-0170-01 Glucotrol XL
00049-0174-03 Glucotrol XL
68012-0003-16 Glumetza ER
68012-0002-13 Glumetza ER
52817-0120-10 Glyburide
65862-0028-01 Glyburide
00093-8342-01 Glyburide
00093-9477-53 Glyburide
23155-0056-01 Glyburide
52817-0121-10 Glyburide
68382-0657-01 Glyburide
00093-9433-01 Glyburide
00093-8343-01 Glyburide
00093-8343-05 Glyburide
00093-8343-10 Glyburide
00093-8343-98 Glyburide
23155-0057-01 Glyburide
65862-0029-01 Glyburide
23155-0058-01 Glyburide
52817-0122-00 Glyburide
52817-0122-10 Glyburide
68382-0658-10 Glyburide
00093-8344-01 Glyburide
65862-0030-01 Glyburide
23155-0058-10 Glyburide
00093-9364-05 Glyburide
57237-0022-05 Glyburide
00093-8344-10 Glyburide
00093-9364-01 Glyburide
00093-8344-05 Glyburide
00093-9364-10 Glyburide
65862-0030-99 Glyburide
00093-8344-98 Glyburide
00093-9433-05 Glyburide
51079-0872-20 Glyburide
51079-0873-20 Glyburide
63739-0119-10 Glyburide
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Appendix 2: Essential Diabetes Drugs NDC List
Page 6 of 16
NDC Essential Diabetes Drug Name
00093-8034-01 Glyburide Micro
00143-9919-01 Glyburide Micro
00093-8035-01 Glyburide Micro
00143-9920-01 Glyburide Micro
00093-8036-01 Glyburide Micro
00093-8035-05 Glyburide Micro
00143-9918-01 Glyburide Micro
00143-9920-05 Glyburide Micro
00378-1125-10 Glyburide Micro
00228-2752-11 Glyburide-Metformin
65862-0081-01 Glyburide-Metformin
57237-0024-05 Glyburide-Metformin
68382-0654-05 Glyburide-Metformin
57237-0024-01 Glyburide-Metformin
68382-0655-05 Glyburide-Metformin
00093-5712-05 Glyburide-Metformin
57237-0025-05 Glyburide-Metformin
00228-2753-11 Glyburide-Metformin
57237-0025-01 Glyburide-Metformin
65862-0082-01 Glyburide-Metformin
65862-0082-05 Glyburide-Metformin
57237-0023-01 Glyburid-Metformin
65862-0080-01 Glyburid-Metformin
00009-0341-01 Glynase
00009-5014-01 Glyset
00009-5012-01 Glyset
00009-5013-01 Glyset
54868-4203-00 Glyset
00597-0182-30 Glyxambi
00597-0182-90 Glyxambi
00597-0164-30 Glyxambi
00597-0164-90 Glyxambi
00597-0182-39 Glyxambi
00597-0164-39 Glyxambi
00002-7516-59 Humalog
00002-8799-59 Humalog
00002-8799-01 Humalog
00002-7510-01 Humalog
00002-7510-17 Humalog
00002-7712-01 Humalog
00002-7712-27 Humalog
00002-7714-59 Humalog Jr
00002-8798-01 Humalog 50-50
00002-8798-59 Humalog 50-50
00002-7512-01 Humalog 50-50
00002-8797-59 Humalog 75-25
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Appendix 2: Essential Diabetes Drugs NDC List
Page 7 of 16
NDC Essential Diabetes Drug Name
00002-7511-01 Humalog 75-25
00002-8803-01 Humulin 70/30
00002-8803-59 Humulin 70/30
00002-8715-17 Humulin 70/30
00002-8715-01 Humulin 70/30
00002-8805-59 Humulin N
00002-8315-17 Humulin N
00002-8315-01 Humulin N
00002-8215-01 Humulin R
00002-8215-17 Humulin R
00002-8824-27 Humulin R500
00002-8501-01 Humulin R500
50458-0543-60 Invokamet
50458-0542-60 Invokamet
50458-0541-60 Invokamet
50458-0540-60 Invokamet
50458-0943-01 Invokamet XR
50458-0942-01 Invokamet XR
50458-0941-01 Invokamet XR
50458-0940-01 Invokamet XR
50458-0140-30 Invokana
50458-0140-90 Invokana
50458-0141-30 Invokana
50458-0141-90 Invokana
00006-0577-61 Janumet
00006-0577-82 Janumet
00006-0577-62 Janumet
00006-0575-61 Janumet
00006-0575-62 Janumet
00006-0575-82 Janumet
00006-0081-54 Janumet XR
00006-0081-31 Janumet XR
00006-0081-82 Janumet XR
00006-0080-82 Janumet XR
00006-0080-61 Janumet XR
00006-0080-62 Janumet XR
00006-0078-62 Janumet XR
00006-0078-61 Janumet XR
00006-0277-01 Januvia
00006-0277-02 Januvia
00006-0277-28 Januvia
00006-0277-31 Januvia
00006-0277-54 Januvia
00006-0277-82 Januvia
00006-0221-54 Januvia
00006-0221-28 Januvia
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Appendix 2: Essential Diabetes Drugs NDC List
Page 8 of 16
NDC Essential Diabetes Drug Name
00006-0221-31 Januvia
00006-0112-54 Januvia
00006-0112-28 Januvia
00006-0112-31 Januvia
00006-0277-33 Januvia
00597-0152-30 Jardiance
00597-0152-90 Jardiance
00597-0153-90 Jardiance
00597-0153-30 Jardiance
00597-0152-37 Jardiance
00597-0153-37 Jardiance
00597-0148-60 Jentadueto
00597-0148-18 Jentadueto
00597-0146-60 Jentadueto
00597-0146-18 Jentadueto
00597-0147-60 Jentadueto
00597-0147-18 Jentadueto
00597-0270-73 Jentadueto XR
00597-0275-33 Jentadueto XR
00597-0275-81 Jentadueto XR
00597-0270-94 Jentadueto XR
64764-0337-60 Kazano
64764-0335-60 Kazano
00310-6125-60 Kombiglyze XR
00310-6145-30 Kombiglyze XR
00310-6135-30 Kombiglyze XR
00088-2220-33 Lantus
00088-5021-01 Lantus
00088-2219-05 Lantus
00088-5020-05 Lantus
00169-3687-12 Levemir
00169-6438-10 Levemir
53746-0220-01 Metformin
42806-0315-05 Metformin
65862-0010-05 Metformin
50742-0156-10 Metformin
53746-0220-10 Metformin
53746-0220-05 Metformin
49483-0620-10 Metformin
50742-0156-05 Metformin
68382-0760-10 Metformin
67877-0221-01 Metformin
67877-0221-05 Metformin
67877-0221-10 Metformin
43547-0359-50 Metformin
43547-0359-10 Metformin
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Appendix 2: Essential Diabetes Drugs NDC List
Page 9 of 16
NDC Essential Diabetes Drug Name
65162-0220-50 Metformin
65162-0220-11 Metformin
68645-0545-59 Metformin
68645-0546-59 Metformin
42806-0221-05 Metformin
00093-7214-01 Metformin
68645-0300-59 Metformin
68462-0161-05 Metformin
67877-0563-01 Metformin
00378-7187-05 Metformin
23155-0104-05 Metformin
23155-0104-10 Metformin
65862-0010-99 Metformin
00093-7214-10 Metformin
68382-0760-05 Metformin
65862-0010-01 Metformin
68382-0030-10 Metformin
57664-0474-88 Metformin
57664-0474-58 Metformin
68382-0760-01 Metformin
67877-0563-05 Metformin
67877-0563-10 Metformin
57664-0474-51 Metformin
68382-0030-05 Metformin
68382-0030-01 Metformin
23155-0104-01 Metformin
57664-0474-53 Metformin
65162-0220-10 Metformin
00093-1048-10 Metformin
50742-0154-90 Metformin
50742-0154-10 Metformin
68645-0544-59 Metformin
68382-0758-05 Metformin
68382-0758-10 Metformin
43547-0357-10 Metformin
00093-1048-01 Metformin
50742-0154-05 Metformin
00378-7185-05 Metformin
68645-0539-59 Metformin
67877-0561-01 Metformin
67877-0217-05 Metformin
67877-0561-10 Metformin
67877-0561-05 Metformin
68382-0028-10 Metformin
53746-0218-01 Metformin
65862-0008-01 Metformin
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Appendix 2: Essential Diabetes Drugs NDC List
Page 10 of 16
NDC Essential Diabetes Drug Name
53746-0218-05 Metformin
50742-0154-01 Metformin
65862-0008-05 Metformin
42806-0213-10 Metformin
42806-0213-05 Metformin
00904-6326-61 Metformin
68462-0159-01 Metformin
60505-0190-00 Metformin
68462-0159-05 Metformin
42806-0313-05 Metformin
57664-0397-58 Metformin
57664-0397-53 Metformin
65862-0008-99 Metformin
58657-0640-10 Metformin
68462-0159-10 Metformin
23155-0102-01 Metformin
23155-0102-05 Metformin
23155-0102-10 Metformin
57664-0397-51 Metformin
53746-0218-10 Metformin
43547-0357-50 Metformin
68382-0758-01 Metformin
43547-0357-11 Metformin
43547-0248-50 Metformin
67877-0217-10 Metformin
67877-0562-10 Metformin
49483-0621-10 Metformin
57664-0435-58 Metformin
57664-0435-88 Metformin
67877-0562-05 Metformin
65862-0009-05 Metformin
68382-0759-10 Metformin
68382-0759-05 Metformin
57664-0435-53 Metformin
00378-7186-05 Metformin
68382-0759-01 Metformin
68462-0160-01 Metformin
68645-0547-59 Metformin
23155-0103-01 Metformin
23155-0103-05 Metformin
23155-0103-10 Metformin
65862-0009-01 Metformin
43547-0358-50 Metformin
53746-0219-05 Metformin
50742-0155-10 Metformin
50742-0155-05 Metformin
DRAFT
Appendix 2: Essential Diabetes Drugs NDC List
Page 11 of 16
NDC Essential Diabetes Drug Name
53746-0219-01 Metformin
50742-0155-01 Metformin
68645-0549-59 Metformin
00093-1049-10 Metformin
53746-0219-10 Metformin
43547-0249-50 Metformin
42806-0314-01 Metformin
57664-0435-51 Metformin
42806-0215-01 Metformin
00591-2412-19 Metformin
68682-0018-90 Metformin
68180-0339-09 Metformin
00378-6002-91 Metformin
68180-0336-07 Metformin
00591-2719-60 Metformin
00093-7267-01 Metformin
68682-0017-10 Metformin
00185-4416-01 Metformin
53746-0178-10 Metformin
00093-7267-10 Metformin
67877-0159-05 Metformin
53746-0178-05 Metformin
53746-0178-90 Metformin
67877-0159-01 Metformin
00781-5503-01 Metformin
62037-0571-01 Metformin
68180-0338-01 Metformin
60505-0260-02 Metformin
60505-0260-01 Metformin
62037-0571-10 Metformin
62756-0142-01 Metformin
62756-0142-02 Metformin
51224-0007-50 Metformin
51224-0007-60 Metformin
67877-0159-10 Metformin
53746-0178-01 Metformin
49483-0623-10 Metformin
49483-0623-50 Metformin
49483-0623-09 Metformin
49483-0623-01 Metformin
62756-0143-01 Metformin
33342-0240-11 Metformin
60505-1329-01 Metformin
49483-0624-01 Metformin
53746-0179-01 Metformin
62037-0577-01 Metformin
DRAFT
Appendix 2: Essential Diabetes Drugs NDC List
Page 12 of 16
NDC Essential Diabetes Drug Name
00093-7212-01 Metformin
51224-0107-50 Metformin
51224-0107-60 Metformin
51927-3105-00 Metformin
38779-2126-05 Metformin
60687-0143-01 Metformin
29033-0032-06 Metformin ER
00591-2720-60 Metformin ER
68180-0337-07 Metformin ER
00378-6001-91 Metformin ER
57664-0686-88 Miglitol
57664-0684-88 Miglitol
57664-0685-88 Miglitol
55111-0329-90 Nateglinide
00591-3355-01 Nateglinide
49884-0985-01 Nateglinide
68382-0722-16 Nateglinide
49884-0984-01 Nateglinide
68084-0458-21 Nateglinide
55111-0328-90 Nateglinide
68382-0721-16 Nateglinide
00591-3354-01 Nateglinide
68084-0459-21 Nateglinide
64764-0125-30 Nesina
64764-0250-30 Nesina
64764-0625-30 Nesina
00169-1837-11 Novolin 70-30
00169-1834-11 Novolin N
00169-1833-11 Novolin R
00169-3303-12 Novolog
00169-7501-11 Novolog
32849-0500-81 Novolog
00169-6339-10 Novolog
00169-3696-19 Novolog 70/30
00169-3685-12 Novolog 70/30
00310-6100-30 Onglyza
00310-6105-50 Onglyza
00310-6105-30 Onglyza
00310-6105-90 Onglyza
00310-6100-90 Onglyza
64764-0121-03 Oseni
64764-0251-03 Oseni
64764-0253-03 Oseni
00169-4132-12 Ozempic
00169-4136-02 Ozempic
00378-0048-77 Pioglitazone
DRAFT
Appendix 2: Essential Diabetes Drugs NDC List
Page 13 of 16
NDC Essential Diabetes Drug Name
13668-0140-90 Pioglitazone
13668-0140-30 Pioglitazone
33342-0054-07 Pioglitazone
33342-0054-10 Pioglitazone
33342-0054-15 Pioglitazone
16729-0020-15 Pioglitazone
00378-0048-93 Pioglitazone
16729-0020-10 Pioglitazone
54458-0866-10 Pioglitazone
16729-0020-16 Pioglitazone
00093-7271-98 Pioglitazone
00591-3205-05 Pioglitazone
00093-7271-56 Pioglitazone
00591-3205-30 Pioglitazone
00781-5420-92 Pioglitazone
00781-5420-31 Pioglitazone
00591-3205-19 Pioglitazone
16729-0021-16 Pioglitazone
00378-0228-77 Pioglitazone
16729-0021-15 Pioglitazone
00093-7272-98 Pioglitazone
00093-7272-56 Pioglitazone
00378-0228-93 Pioglitazone
16729-0021-10 Pioglitazone
13668-0119-90 Pioglitazone
13668-0119-05 Pioglitazone
33342-0055-07 Pioglitazone
33342-0055-10 Pioglitazone
54458-0865-10 Pioglitazone
00093-2047-98 Pioglitazone
00591-3206-19 Pioglitazone
33342-0055-15 Pioglitazone
00781-5421-92 Pioglitazone
00781-5421-31 Pioglitazone
00591-3206-30 Pioglitazone
13668-0119-30 Pioglitazone
00093-2046-98 Pioglitazone
16729-0022-15 Pioglitazone
00781-5422-31 Pioglitazone
13668-0120-05 Pioglitazone
13668-0120-30 Pioglitazone
13668-0120-90 Pioglitazone
16729-0022-10 Pioglitazone
00591-3207-30 Pioglitazone
00093-7273-56 Pioglitazone
00591-3207-05 Pioglitazone
DRAFT
Appendix 2: Essential Diabetes Drugs NDC List
Page 14 of 16
NDC Essential Diabetes Drug Name
00781-5422-92 Pioglitazone
16729-0022-16 Pioglitazone
00378-0318-93 Pioglitazone
33342-0056-07 Pioglitazone
33342-0056-10 Pioglitazone
54458-0864-10 Pioglitazone
63304-0313-30 Pioglitazone
00093-7273-98 Pioglitazone
00591-3207-19 Pioglitazone
51079-0513-20 Pioglitazone
68084-0878-01 Pioglitazone
66993-0821-30 Pioglitazone-Glimepiride
00781-5634-31 Pioglitazone-Glimepiride
66993-0822-30 Pioglitazone-Glimepiride
00781-5635-31 Pioglitazone-Glimepiride
13668-0280-60 Pioglitazone-Metformin
65862-0525-60 Pioglitazone-Metformin
00781-5626-60 Pioglitazone-Metformin
00093-7677-06 Pioglitazone-Metformin
00378-1550-91 Pioglitazone-Metformin
13668-0281-60 Pioglitazone-Metformin
57237-0218-60 Pioglitazone-Metformin
00093-7678-06 Pioglitazone-Metformin
65862-0526-18 Pioglitazone-Metformin
65862-0526-60 Pioglitazone-Metformin
33342-0177-09 Pioglitazone-Metformin
00378-1575-91 Pioglitazone-Metformin
00781-5627-60 Pioglitazone-Metformin
60846-0884-01 Prandin
60846-0882-01 Prandin
00169-1837-02 Novolin 70-30
00169-1834-02 Novolin N
00169-1833-02 Novolin R
10631-0206-01 Riomet
10631-0206-02 Riomet
10631-0238-01 Riomet
10631-0238-02 Riomet
00006-5373-03 Segluromet
00006-5373-06 Segluromet
00006-5369-03 Segluromet
00006-5369-06 Segluromet
00006-5374-03 Segluromet
00006-5374-06 Segluromet
00006-5370-03 Segluromet
00006-5370-06 Segluromet
00024-5761-05 Soliqua 100/33
DRAFT
Appendix 2: Essential Diabetes Drugs NDC List
Page 15 of 16
NDC Essential Diabetes Drug Name
00078-0352-05 Starlix
00078-0351-05 Starlix
00006-5364-03 Steglatro
00006-5364-06 Steglatro
00006-5368-03 Steglujan
00006-5368-06 Steglujan
00006-5367-03 Steglujan
00006-5367-06 Steglujan
00310-6627-02 Symlinpen
00310-6615-02 Symlinpen
00597-0168-18 Synjardy
00597-0168-60 Synjardy
00597-0180-60 Synjardy
00597-0180-18 Synjardy
00597-0175-60 Synjardy
00597-0175-18 Synjardy
00597-0159-18 Synjardy
00597-0159-60 Synjardy
00597-0280-90 Synjardy
00597-0290-74 Synjardy
00597-0280-73 Synjardy XR
00597-0300-93 Synjardy XR
00597-0300-45 Synjardy XR
00597-0295-88 Synjardy XR
00597-0295-78 Synjardy XR
00597-0290-59 Synjardy XR
00173-0866-01 Tanzeum
00173-0866-35 Tanzeum
00173-0867-35 Tanzeum
00024-5871-02 Toujeo
00024-5869-03 Toujeo
00597-0140-61 Tradjenta
00597-0140-30 Tradjenta
00597-0140-90 Tradjenta
00169-2660-15 Tresiba
00169-2550-13 Tresiba
00002-1433-01 Trulicity
00002-1433-80 Trulicity
00002-1434-01 Trulicity
00002-1434-80 Trulicity
00169-4060-12 Victoza
00169-4060-13 Victoza
65597-0902-30 Welchol
65597-0701-18 Welchol
00310-6280-30 Xigduo XR
00310-6270-30 Xigduo XR
DRAFT
Appendix 2: Essential Diabetes Drugs NDC List
Page 16 of 16
NDC Essential Diabetes Drug Name
00310-6260-60 Xigduo XR
00310-6250-30 Xigduo XR
00169-2911-15 Xultophy 100/3.6
DRAFT