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 |
|---|---|---|---|---|---|
| NORGESIC 25-385-30 MG TABLET | ORPHENADRINE/ASPIRIN/CAFFEINE | 02/02/2023 | 03/14/2023 | PDL Product | July 2023 |
| OZEMPIC 0.25-0.5 MG/DOSE PEN | SEMAGLUTIDE | 01/17/2023 | 02/28/2023 | PDL Product | July 2023 |
| LEQEMBI 500 MG/5 ML VIAL | LECANEMAB-IRMB | 01/17/2023 | 02/28/2023 | Clinical Edit | July 2023 |
| LEQEMBI 200 MG/2 ML VIA | LECANEMAB-IRMB | 01/17/2023 | 02/28/2023 | Clinical Edit | July 2023 |
| BRIUMVI 150 MG/6 ML VIAL | UBLITUXIMAB-XIIY 150 MG/6 ML VIAL | 01/10/2023 | 02/21/2023 | PDL Product | July 2023 |
| NALOXONE 10 MG AUTO-INJECTOR | Nalxone HCL | 01/10/2023 | 02/21/2023 | PDL Product | July 2023 |
| AUVI-Q 0.1 MG AUTO-INJECTOR | Epinephrine | 01/10/2023 | 02/21/2023 | PDL Product | July 2023 |
| SUNLENCA 4- 300 MG TABLET | LENACAPAVIR SODIUM | 01/03/2023 | 02/14/2023 | PDL Product | July 2023 |
| SUNLENCA 463.5 MG/1.5 ML VIAL | LENACAPAVIR SODIUM | 01/03/2023 | 02/14/2023 | PDL Product | July 2023 |
| OXBRYTA 300 MG TABLET | VOXELOTOR | 01/03/2023 | 02/14/2023 | Clinical Edit | July 2023 |
| SKYRIZI 180 MG/1.2 ML ON-BODY | RISANKIZUMAB-RZAA | 12/27/2022 | 02/07/2023 | PDL Product | April 2023 |
| STIMUFEND 6 MG/0.6 ML SYRINGE | PEGFILGRASTIM-FPGK 6 MG/0.6ML SYRINGE SUBCUT | 12/20/2022 | 01/31/2023 | PDL Product | April 2023 |
| REBYOTA RECTAL SUSPENSION | FECAL MICROBIOTA, LIVE-JSLM 150 ML ENEMA RECTAL | 12/20/2022 | 01/31/2023 | Fiscal Edit | April 2023 |
| TASCENSO ODT 0.5 MG TABLET | FINGOLIMOD LAURYL SULFATE 0.5 MG TAB RAPDIS ORAL | 12/20/2022 | 01/31/2023 | PDL Product | April 2023 |
| TZIELD 2MG/2ML VIAL | TEPLIZUMAB-MZWV | 12/15/2022 | 01/24/2023 | Clinical Edit | April 2023 |