Submission Form for Addition of New Drug to the SDAP Formulary
The Colorado State Drug Assistance Program's (SDAP) Medical Advisory Committee (MAC) will review drug requests as scheduling of the MAC permits, and the MAC may elect to withhold review and decision of newly marketed drugs pending FDA approval, price negotiations, and CDPHE cost analysis.

Complete the form to the best of your ability.

The current SDAP formulary can be found here: https://drive.google.com/file/d/1kFoQZfYDgkBsaJBubiF7xIROm8zL6fZu/view
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Who is making this request? *
This request to add a new drug is intended: *
Required
Drug Generic Name
Drug Brand/Trade Name
Drug Strength(s)
Dosage Form
Clear selection
Is a specific brand necessary?
Clear selection
If yes, please list the manufacturer:
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