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 111 -115 KG (10ML X23) | ETRANACOGENE DEZAPARVOVEC - DRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 141 -145 KG (10ML X29) | ETRANACOGENE DEZAPARVOVEC - DRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 166 -170 KG (10ML X34) | ETRANACOGENE DEZAPARVOVEC - DRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 161 -165 KG (10ML X33) | ETRANACOGENE DEZAPARVOVEC - DRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 116 -120 KG (10ML X24) | ETRANACOGENE DEZAPARVOVEC - DRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 156 -160 KG (10ML X32) | ETRANACOGENE DEZAPARVOVEC - DRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 151 -155 KG (10ML X31) | ETRANACOGENE DEZAPARVOVEC - DRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 136 -140 KG (10ML X28) | ETRANACOGENE DEZAPARVOVEC - DRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 146 -150 KG (10ML X30) | ETRANACOGENE DEZAPARVOVEC - DRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 186 -190 KG (10ML X38) | ETRANACOGENE DEZAPARVOVEC - DRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 46-50 KG (10ML X10) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 121-125 KG (10ML X25) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 56-50 KG (10ML X12) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 61-65 KG (10ML X13) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 66-70 KG (10ML X14) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |