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 |
|---|---|---|---|---|---|
| HEMGENIX 191-195 KG (10ML X39) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 201-205 KG (10ML X41) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 206-210 KG (10ML X42) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 211-215 KG (10ML X43) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 216-220 KG (10ML X44) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 221-225 KG (10ML X45) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 226-230 KG (10ML X46) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 236-240 KG (10ML X48) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 11/07/2023 | Clinical Edit | April 2023 |
| HEMGENIX 51-55 KG (10ML X11) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 196-200 KG (10ML X40) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 91-95 KG (10ML X19) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 96-100 KG (10ML X20) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 10 ML VIAL | ETRANACOGENE DEZAPARVOVEC - DRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 101 -110 KG (10ML X21) | ETRANACOGENE DEZAPARVOVEC - DRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 106 -110 KG (10ML X22) | ETRANACOGENE DEZAPARVOVEC - DRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |