Drugs with Coverage Limitations and New Drug Review
Please Note:
- Date Review Completed and Conclusion columns are blank for those products currently undergoing review. Details will be updated as efficiently as possible following initial review.
- Conclusions are based upon decisions made at the time reviews are completed; historical information is not updated. Product management is subject to change based on new clinical evidence, provider/public feedback, advisory committee recommendations, financial considerations, etc.
- This contains approximately one year of New Drug details.
- Advisory Meeting Month is the month this recommendation will be presented at the quarterly Drug Prior Authorization Committee (DPAC) and Drug Utilization Review (DUR) Board meetings. For meeting dates, please see the MO HealthNet Calendar of Events. Certain agents may also be discussed at the quarterly Rare Disease Advisory Council meeting immediately prior to their presentation at their designated DPAC/DUR meeting.
For more information on this process please view the New Drug Review Process or contact the MO HealthNet Pharmacy Program at MHD.PharmacyAdmin@dss.mo.gov or call 573-751-6963.
| Trade Name | Generic Name | Date Review Began | Date Review Completed | Conclusion | Advisory Committee Month |
|---|---|---|---|---|---|
| TIROSINT 44 MCG CAPSULE | LEVOTHYROXINE SODIUM | 04/04/2023 | 05/16/2023 | Fiscal Edit | October 2023 |
| JOENJA 70 MG TABLET | LENIOLISIB PHOSPHATE | 04/04/2023 | 05/23/2023 | Clinical Edit | July 2023 |
| ZOLGENSMA 20.1-20.5 KG KIT | ONASEMNOGENE ABEPARVOVECXIOI | 04/04/2023 | 05/16/2023 | Clinical Edit | October 2023 |
| TIROSINT 62.5 MCG CAPSULE | LEVOTHYROXINE SODIUM | 04/04/2023 | 05/16/2023 | Fiscal Edit | October 2023 |
| DAYBUE 200 MG/ML SOLUTION | TROFINETIDE | 03/21/2023 | 05/02/2023 | Clinical Edit | July 2023 |
| REZVOGLAR 100 UNIT/ML KWIKPEN | INSULIN GLARGINE-AGLR | 03/14/2023 | 04/25/2023 | PDL Product | July 2023 |
| ATORVALIQ 20 MG/5 ML SUSP | ATORVASTATIN CALCIUM | 03/14/2023 | 04/25/2023 | PDL Product | July 2023 |
| OXYBUTYNIN 2.5 MG TABLET | OXYBUTYNIN CHLORIDE | 03/06/2023 | 04/19/2023 | PDL Product | July 2023 |
| FUROSCIX 80 MG/10ML ON-BODY KT | FUROSEMIDE | 03/06/2023 | 04/19/2023 | Fiscal Edit | July 2023 |
| KONVOMEP 2-84 MG/ML ORAL SUSP | OMEPRAZOLE/SODIUM BICARBONATE | 03/06/2023 | 04/19/2023 | PDL Product | July 2023 |
| ORENITRAM MONTH 1 TITRATION KT | TREPROSTINIL DIOLAMINE 0.125-0.25 MG | 02/28/2023 | 04/11/2023 | PDL Product | July 2023 |
| FILSPARI 400 MG TABLET | SPARSENTAN | 02/28/2023 | 04/11/2023 | Clinical Edit | July 2023 |
| FILSPARI 200 MG TABLET | SPARSENTAN | 02/28/2023 | 04/11/2023 | Clinical Edit | July 2023 |
| SYFOVRE 15 MG/0.1 ML VIAL | PEGCETACOPLAN/PF | 02/28/2023 | 04/11/2023 | Open Access | July 2023 |
| ERLEADA 240 MG TABLET | APALUTAMIDE | 02/28/2023 | 04/11/2023 | PDL Product | July 2023 |