Reference Drug Program—list of full and partial benefits

Last updated on January 31, 2024

This table lists the drugs in the Reference Drug Program (RDP) and, for each drug, indicates if the drug is eligible for full or partial coverage.

RDP Honeycomb

Medical evidence shows that drugs within each therapeutic category are equally safe and effective.

Partial coverage indicates the non-reference drug will be covered up to a maximum amount based on the cost of the reference drug(s) in the category, which are the most cost-effective

RDP—List of full and partial benefits
RDP Category Drug name (chemical name) RDP Coverage status Requires Special Authority for full coverage?
(Click "Yes" for criteria and forms)
Angiotensin converting enzyme inhibitors (ACEIs) benazepril Partially covered Yes
Angiotensin converting enzyme inhibitors (ACEIs) captopril Partially covered Yes
Angiotensin converting enzyme inhibitors (ACEIs) cilazapril with/without HCTZ Partially covered Yes
Angiotensin converting enzyme inhibitors (ACEIs) enalapril with/without HCTZ Partially covered Yes
Angiotensin converting enzyme inhibitors (ACEIs) fosinopril Partially covered Yes
Angiotensin converting enzyme inhibitors (ACEIs) lisinopril with/without HCTZ Partially covered Yes
Angiotensin converting enzyme inhibitors (ACEIs) perindopril Partially covered Yes
Angiotensin converting enzyme inhibitors (ACEIs) quinapril with/without HCTZ Partially covered Yes
Angiotensin converting enzyme inhibitors (ACEIs) ramipril with/without HCTZ Fully covered No
Angiotensin converting enzyme inhibitors (ACEIs) trandolapril Partially covered Yes
Angiotensin receptor blockers (ARBs) candesartan with/without HCTZ Fully covered Yes
Angiotensin receptor blockers (ARBs) eprosartan with/without HCTZ Partially covered Yes
Angiotensin receptor blockers (ARBs) irbesartan with/without HCTZ Partially covered Yes
Angiotensin receptor blockers (ARBs) losartan with/without HCTZ Fully covered Yes
Angiotensin receptor blockers (ARBs) olmesartan with/without HCTZ Partially covered Yes
Angiotensin receptor blockers (ARBs) telmisartan with/without HCTZ or amlodipine Fully covered Yes
Angiotensin receptor blockers (ARBs) valsartan with/without HCTZ Fully covered Yes
Dihydropyridine calcium channel blockers (CCBs) amlodipine Fully covered No
Dihydropyridine calcium channel blockers (CCBs) felodipine Partially covered Yes
Dihydropyridine calcium channel blockers (CCBs) nifedipine Partially covered Yes
Histamine2 receptor blockers (H2 blockers) cimetidine Partially covered Yes
Histamine2 receptor blockers (H2 blockers) famotidine Partially covered Yes
Histamine2 receptor blockers (H2 blockers) nizatidine Partially covered Yes
Histamine2 receptor blockers (H2 blockers) ranitidine Fully covered No
Non-steroidal anti-inflammatory drugs (NSAIDs)* diclofenac  Partially covered Yes
Non-steroidal anti-inflammatory drugs (NSAIDs)* ibuprofen Fully covered No
Non-steroidal anti-inflammatory drugs (NSAIDs)* naproxen Fully covered No
Non-steroidal anti-inflammatory drugs (NSAIDs)* naproxen EC Partially covered Yes
Non-steroidal anti-inflammatory drugs (NSAIDs)* naproxen SR Partially covered Yes
Proton pump inhibitors (PPIs) esomeprazole 20 or 40 mg Partially covered Yes
Proton pump inhibitors (PPIs) lansoprazole 15 or 30 mg Partially covered Yes
Proton pump inhibitors (PPIs) omeprazole 20 mg Partially covered Yes
Proton pump inhibitors (PPIs) pantoprazole magnesium 40 mg Fully covered Yes
Proton pump inhibitors (PPIs) pantoprazole sodium 40 mg Partially covered Yes
Proton pump inhibitors (PPIs) rabeprazole 10 and 20 mg Fully covered Yes
Statins atorvastatin Fully covered No
Statins fluvastatin Partially covered Yes
Statins lovastatin Partially covered Yes
Statins pravastatin Partially covered Yes
Statins rosuvastatin Fully covered No
Statins simvastatin Partially covered Yes

* NSAIDs not listed here are not included in the RDP and are Limited Coverage Drugs requiring Special Authority. Please consult the Special Authority drug list for criteria and forms