Drugs with Coverage Limitations and New Drug Review header

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(link sends email) or call 573-751-6963. 

Trade Name Generic Name Date Review Began Date Review Completed Conclusion Advisory Committee Month
LAMZEDE 10 MG VIAL VELMANASE ALFA-TYCV 02/28/2023 04/11/2023 Clinical Edit July 2023
ORENITRAM MONTH 3 TITRATION KT TREPROSTINIL DIOLAMINE 0.125-1 MG 02/28/2023 04/11/2023 PDL Product July 2023
ORENITRAM MONTH 2 TITRATION KT TREPROSTINIL DIOLAMINE 0.125-0.25 MG 02/28/2023 04/11/2023 PDL Product July 2023
PRADAXA 40 MG PELLET PACK DABIGATRAN ETEXILATE MESYLATE 02/21/2023 04/04/2023 PDL Product July 2023
PRADAXA 30 MG PELLET PACK DABIGATRAN ETEXILATE MESYLATE 02/21/2023 04/04/2023 PDL Product July 2023
PRADAXA 20 MG PELLET PACK DABIGATRAN ETEXILATE MESYLATE 02/21/2023 04/04/2023 PDL Product July 2023
TAKHZYRO 150 MG/ML SYRINGE LANADELUMAB-FLYO 02/21/2023 04/04/2023 Fiscal Edit July 2023
PRADAXA 150 MG PELLET PACK DABIGATRAN ETEXILATE MESYLATE 02/21/2023 04/04/2023 PDL Product July 2023
PRADAXA 110 MG PELLET PACK DABIGATRAN ETEXILATE MESYLATE 02/21/2023 04/04/2023 PDL Product July 2023
PRADAXA 50 MG PELLET PACK DABIGATRAN ETEXILATE MESYLATE 02/21/2023 04/04/2023 PDL Product July 2023
TEZSPIRE 210 MG/1.91 ML PEN TEZEPELUMAB-EKKO 02/14/2023 03/28/2023 PDL Product July 2023
AMJEVITA 40 MG/0.8 ML SYRINGE ADALIMUMAB-ATTO 02/07/2023 03/21/2023 PDL Product July 2023
AMJEVITA 20 MG/0.4 ML SYRINGE ADALIMUMAB-ATTO 02/07/2023 03/21/2023 PDL Product July 2023
APONVIE 32 MG/4.4 ML VIAL APREPITANT 02/07/2023 03/21/2023 PDL Product July 2023
AMJEVITA 40 MG/0.8 ML AUTOINJ ADALIMUMAB-ATTO 02/07/2023 03/21/2023 PDL Product July 2023