Clinical Criteria
ADD/ADHD Agents (Revised March 21, 2019)*
Alinia (Revised March 21, 2019)*
Aliskiren Containing Agents (Revised March 21, 2019)*
Allergen Extracts (Revised July 15, 2019)*
Altabax (Revised March 21, 2019)*
Androgenic Agents (Pending Implementation) (Revised March 21, 2019)*
Antiemetic Agents (Revised March 21, 2019)*
Antipsychotic Agents (Revised March 22, 2019)*
Anxiolytics and Sedative-Hypnotics (Revised March 22, 2019)*
Arikayce (Pending Implementation) (Revised April 26, 2019)*
Buprenorphine Agents (Revised March 22, 2019)*
Carisoprodol Overuse (Revised March 26, 2019)*
Carisoprodol-Containing Agents (Pending Implementation) (Revised May 23, 2019)*
CGRP Antagonists (Pending Implementation) (Revised March 26, 2019)*
Colcrys (Pending Implementation) (Revised March 26, 2019)*
Cough & Cold (Revised March 26, 2019)*
COX-2 Inhibitors (Revised March 26, 2019)*
Cyclobenzaprine (Revised March 27, 2019)*
Cymbalta (Revised March 27, 2019)*
Cystic Fibrosis Agents (Pending Implementation) (Revised July 10, 2019)*
Cystic Fibrosis Agents (Revised May 9, 2019)*
Cytokine and CAM Antagonists (Pending Implementation) (Revised July 30, 2019)*
Cytokine and CAM Antagonists (Revised May 20, 2019)*
Desmopressin (Revised March 27, 2019)*
Dextromethorphan Overutilization (Revised March 27, 2019)*
Diabetic Test Strips (Pending Implementation) (Revised March 27, 2019)*
Diclofenac (Pending Implementation) (Revised March 27, 2019)*
DPP4 Inhibitors (Revised March 27, 2019)*
Drug Regimen Optimization (Revised April 3, 2015)*
Dupixent (Revised March 28, 2019)*
Duplicate Therapy (Revised July 1, 2019)*
Emflaza (Pending Implementation) (Revised July 3, 2019)*
Emflaza (Revised March 28, 2019)*
Enzymes (Pending Implementation) (Revised March 28, 2019)*
Epidiolex (Pending Implementation) (Revised March 28, 2019)*
Erythropoiesis-Stimulating Agents (Revised March 28, 2019)*
Fentanyl Agents (Revised March 28, 2019)*
Forteo (Pending Implementation) (Revised March 28, 2019)*
Gabapentin Agents (Revised March 29, 2019)*
Gaucher's Disease Agents (Pending Implementation) (Revised July 15, 2019)*
GI Motility Agents (Pending Implementation) (Revised July 30, 2019)*
GI Motility Agents (Revised March 29, 2019)*
Glatiramer Acetate Injection (Pending Implementation) (Revised July 15, 2019)*
GLP-1 Receptor Agonists (Pending Implementation) (Revised July 5, 2019)*
GLP-1 Receptor Agonists (Revised March 29, 2019)*
Growth Hormone Agents (Pending Implementation) (Revised March 29, 2019)*
Growth Hormone Agents (Revised March 29, 2019)*
Growth Hormone Quick Reference Guide
HAE Agents (Pending Implementation) (Revised July 15, 2019)*
HP Acthar (Revised July 15, 2019)*
Imiquimod (Revised March 29, 2019)*
Increlex (Revised March 29, 2019)*
Inhaled Antibiotics (Pending Implementation) (Revised April 26, 2019)*
Injectable Agents for PAH (Pending Implementation) (Revised July 15, 2019)*
Ketorolac (Revised March 29, 2019)*
Keveyis (Pending Implementation) (Revised March 29, 2019)*
Leukotriene Modifiers (Revised July 15, 2019)*
Lidocaine Patches (Revised July 15, 2019)*
Lovaza (Revised March 29, 2019)*
Lyrica (Pending Implementation) (Revised May 30, 2019)*
Makena (Revised May 14, 2019)*
Morphine Milligram Equivalent Criteria (Revised July 1, 2019)*
Nuedexta (Revised March 29, 2019)*
Nuplazid (Pending Implementation) (Revised March 29, 2019)*
Opiate Overutilization (Revised July 1, 2019)*
Opiate/Benzodiazepine/Muscle Relaxant Combinations (Revised July 1, 2019)*
Orilissa (Pending Implementation) (Revised March 29, 2019)*
Oxycontin / Narcotic Analgesic (Revised March 29, 2019)*
PCSK9 Inhibitors (Revised March 29, 2019)*
Phosphate Binders (Revised March 29, 2019)*
Plavix (Pending Implementation) (Revised March 29, 2019)*
Promethazine Utilization (Revised March 29, 2019)*
Propylthiouracil (Revised March 29, 2019)*
Proton Pump Inhibitors (Pending Implementation) (Revised March 29, 2019)*
Provigil and Nuvigil (Revised March 29, 2019)*
Ranexa (Revised March 29, 2019)*
Revatio (Revised March 29, 2019)*
Savella (Pending Implementation) (Revised March 29, 2019)*
SGLT2 Agents (Pending Implementation) (Revised May 1, 2019)
Symlin (Revised March 29, 2019)*
Synagis (Revised March 29, 2019)*
Thiazolidinediones (Revised March 29, 2019)*
Topical Acne Agents (Pending Implementation) (Revised March 29, 2019)*
Topical Immunomodulators (Revised March 29, 2019)*
Topical Retinoids (Pending Implementation) (Revised March 29, 2019)*
Urea Cycle Disorder Agents (Pending Implementation) (Revised April 26, 2019)
Valturna (Retired) (Revised August 23, 2017)*
VMAT2 Inhibitors (Revised March 29, 2019)*
Xifaxan (Revised March 29, 2019)*
Xyrem (Revised March 29, 2019)*
Zelboraf (Pending Implementation) (Revised March 29, 2019)*
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Announcements
July 2019 Drug Utilization Review Board Meeting Summary
by TANNER.BAIN on 08/13/2019
The Texas Drug Utilization Review Board met July 26, to make recommendations for Medicaid clinical prior authorizations and the preferred drug list. A summary of this meeting is now available from the Texas Vendor Drug Program website at www.txvendordrug.com. The next meeting is scheduled for Friday, Oct. 25.
Information about Epinephrine Shortage Impacts to Medicaid
by TANNER.BAIN on 07/30/2019
Mylan issued an alert in June on the manufacturing challenges about the production of EpiPen (epinephrine injection, USP) 0.3 mg and EpiPen Jr (epinephrine Injection, USP) 0.15 mg Auto-Injectors, and the authorized generic versions of these strengths. These challenges resulted in the reduced availability of these products. Effective July 26, VDP will temporarily remove the non-preferred status from those NDCs for people enrolled in Medicaid. To learn more, and see the current preferred products, visit the Vendor Drug Program website at https://www.txvendordrug.com/about/current-news.
Revision to Makena Clinical Prior Authorization Criteria, Form
by TANNER.BAIN on 06/18/2019
VDP will revise the Makena clinical prior authorization criteria on August 1. This prior authorization remains optional for Medicaid managed care. Read more at the notice at www.txvendordrug.com/about/current-news.