
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 |
---|---|---|---|---|---|
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 |