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 151 -155 KG (10ML X31) | ETRANACOGENE DEZAPARVOVEC - DRLB 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 66-70 KG (10ML X14) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 111 -115 KG (10ML X23) | ETRANACOGENE DEZAPARVOVEC - DRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 176 -180 KG (10ML X36) | ETRANACOGENE DEZAPARVOVEC - DRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edits | April 2023 |
| HEMGENIX 191-195 KG (10ML X39) | ETRANACOGENE DEZAPARVOVECDRLB 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 221-225 KG (10ML X45) | 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 141 -145 KG (10ML X29) | ETRANACOGENE DEZAPARVOVEC - DRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |
| HEMGENIX 171 -175 KG (10ML X35 | ETRANACOGENE DEZAPARVOVEC - DRLB 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 146 -150 KG (10ML X30) | ETRANACOGENE DEZAPARVOVEC - DRLB 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 56-50 KG (10ML X12) | ETRANACOGENE DEZAPARVOVECDRLB 1X10E13/ML KIT | 12/06/2022 | 01/17/2023 | Clinical Edit | April 2023 |