Your Pharm Aid

September 20, 2023

August 2023 Forward Health Preferred Drug List (PDL) Updates

Several updates were made to the Forward Health Preferred Drug List, effective September 1. Notable changes relevant to family medicine and primary care include the following:

  • COPD Agents
    • Tiotropium (generic Spiriva) is NON-preferred. Forward Health contracting requires brand name Spiriva at this time.
  • Inhaled Glucocorticoids
    • Breyna (budesonide/formoterol, generic Symbicort) is NON-preferred
  • DPP-4 Inhibitors
    • Saxagliptin is now NON-preferred
    • Saxagliptin/metformin ER is also NON-preferred

It was announced that Contrave ER will no longer be covered, effective September 30, 2023.

Additionally, due to ongoing shortages of brand name Vyvanse 60mg and 70mg (preferred agents), generic lisdexamfetamine 60mg and 70mg are temporarily covered, effective September 13, 2023.

Featured Resources: Storage and Stability Calculators

Several medication and vaccine makers have online storage and stability calculators for their branded products. These tools can be very helpful for triaging clinic phone calls from frantic patients asking if they can still use products that were inadvertently left out of the refrigerator, left in a hot vehicle, or exposed to excessively cold temperatures for various periods of time.

Users select the product in question, then indicate the temperature and length of excursion from recommended storage temperatures. The calculator then returns a brief summary of available stability data for that specific product. Each site is armed with a disclaimer that data is not intended to be a substitute for clinical judgement, and it should be noted that this data does not aply to generic versions of these products. Some sites require users to register and/or log in to use the tool, and some allow users to print the data monograph for patient and/or provider review.


Links to various tools are available below. Consider adding them to your favorites to access them:

Over-the-Counter (OTC) Decongestant Ineffective

The Food and Drug Administration’s (FDA) Non-prescription Drug Advisory Committee recently convened to discuss new data revealing the ineffectiveness of recommended doses of orally available phenylephrine currently marketed to consumers for use as a nasal decongestant.  The data applied to both single ingredient phenylephrine and combination ingredient products.  It is important to note that the evidence that was considered did not identify any safety concerns with current doses.  In addition, the advisory committee’s statement did not discuss or raise any concerns with phenylephrine nasal sprays.

Although the above information was widely communicated via many news sources (ex. television, print, internet), the FDA has taken no official action against phenylephrine at this time.  The Non-prescription Drug Advisory Committee serves to provide independent advice and recommendations to the FDA, which is what has occurred at this time.  The FDA will now consider the information shared with them before making any further decisions.  If, after the FDA’s analysis of the data, they confirm that phenylephrine is not effective at currently recommended oral doses, they will then take a series of actions before any disruptions of availability of phenylephrine oral products would occur (ex. reformulation of products to make them effective vs. removal from the market).  The most likely steps the FDA will now take include:

  • A proposed order for removing oral phenylephrine would be issued.
  • The public would then be given the opportunity to comment on the proposal.
  • If after the above occurs oral phenylephrine is still considered ineffective as currently labeled, the FDA would then work with manufactures to either reformulate oral phenylephrine containing products or work through their removal from the market.

Phenylephrine is available in many different OTC formulations, including both as single ingredient and combination products.  They may be labeled as their generic name (ex. phenylephrine) or as a variety of different brand names.  Consumers and providers will need to specifically look at the list of active ingredients to know whether phenylephrine is contained in a product.  A list of some OTC products that contain phenylephrine include:

  • Sudafed PE
  • Benadryl Allergy Plus Congestion
  • Vicks DayQuil Severe Cold and Flu
  • Vicks NyQuil Severe Cold & Flu
  • Tylenol Cold and Flu Severe Day & Night
  • Alka-Seltzer Plus Severe Cold & Flu Formula Effervescent Tablets

Remember, the above listed products are only a brief sampling of the current OTC products that contain phenylephrine.  There are MANY more products under a vast variety of brand names and ingredients in combination.  It is imperative to read the active ingredient list to know if phenylephrine is included.

To read the 89-page briefing document from the FDA’s meeting with the Non-prescription Drug Advisory Committee that took place on September 11-12 (2023) that discussed the above issue, click here: .

To read the FDA’s brief comment related to this, click here: .

Clinical Pharmacy Practitioner in Primary Care

Mike Grunske, PharmD, BCPS

Mike Grunske is a Board-Certified Pharmacotherapy Specialist (BCPS). Mike transitioned his practice to the Clement Zablocki VA Medical Center where he has since practiced in the Primary Care Clinics as a Clinical Pharmacist Practioner. Within this role, his practice involves direct care and management of patients’ medication regimens. He has worked as an active preceptor for both pharmacy students and residents throughout his entire career. Mike is also Past-President and former Foundation Chair of the Pharmacy Society of Wisconsin (PSW).

Mike is married to a fellow PharmAid contributor (Vanessa Grunske). Together they have a teenage daughter and son. He enjoys traveling with his family, attending his kid’s cheer, baseball, and basketball events, and spending any available leftover time running and hunting.

Pharmacist at Advocate Aurora Health

Vanessa Grunske, PharmD, BCACP

Vanessa practices with Advocate Aurora Health in Milwaukee, where she sees patients at Aurora Sinai Medication Management Clinic and maintains a dispensing practice at St. Luke’s Medical Center. Board-certified in ambulatory care pharmacotherapy, her practice interests include diabetes, hypertension, smoking cessation, geriatrics, improving health literacy, and medication adherence. She particularly enjoys and spends a good share of her work hours teaching and mentoring pharmacy students, family medicine residents and pharmacy residents.  

She and her husband, Mike, live in the Milwaukee area with their two teenage children. In her free time, she enjoys cooking, baking, visiting our national parks with her family or relaxing on a beautiful Caribbean beach.

Professor at Concordia University Wisconsin School of Pharmacy

Beth Buckley, PharmD, CDCES

Beth Buckley, PharmD, CDCES (Certified Diabetes Care and Education Specialist), is a Professor of Pharmacy Practice at the Concordia University Wisconsin School of Pharmacy, where she has a teaching role within all years of the curriculum with a focus on Applied Patient Care Skills Lab, Diabetes Pharmacotherapy, and electives in the areas of diabetes and wellness. Her current role is ambulatory care pharmacist where she works with a Collaborative Practice Agreement to provide chronic disease state management within a primary care clinic.

When not working, she enjoys reading, gardening, traveling with her husband, volunteering within the community, and active fun: hiking, biking, dog walking, practicing yoga, mindfulness, and living with intention and gratitude. 

Disclaimer: The Wisconsin Academy of Family Physicians (WAFP) has entered into a business relationship with Pharm Aid to offer our members discounts and exclusive savings. This or other affinity program relationships presented by the WAFP in no way implies a WAFP endorsement of the program, supplier, or vendor.

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