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Preferred Drug List

This is our most recently revised Preferred Drug List. Please note that providers should prescribe from the PDL, and allow generic substitutions when medically appropriate.

BrickStreet Mutual Insurance Company Preferred Drug List Effective 01/01/07.

Please prescribe from the Preferred Drug List (PDL) when medically appropriate.

Schedule II medications require prior authorization two weeks after initial date of injury, per controlled substance guidelines.

Prior to twelve weeks from the initial DOI, medications on the PDL may be prescribed without prior approval or authorization.

Twelve weeks after initial DOI, medication on the PDL require prior authorization.

Medication on the PDL must be tried prior to approval of medication in the same therapeutic class but not on the PDL .

Any medication not on the PDL must be authorized for payment before a prescription can be filled.

An injured worker who receives a brand medication when a generic is available will be personally liable for the difference in cost between Generic and Brand medication.

 
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