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 |
|---|---|---|---|---|---|
| OLPRUVA 6.67 GRAM DOSE ENVELOPE | SODIUM PHENYLBUTYRATE | 08/08/2023 | 09/19/2023 | PDL Product | October 2023 |
| COSENTYX UNOREADY 300 MG PEN | SECUKINUMAB | 08/08/2023 | 09/19/2023 | Fiscal Edit | January 2024 |
| OLPRUVA 4 GRAM DOSE ENVELOPE | SODIUM PHENYLBUTYRATE | 08/08/2023 | 09/19/2023 | PDL Product | October 2023 |
| OLPRUVA 5 GRAM DOSE ENVELOPE | SODIUM PHENYLBUTYRATE | 08/08/2023 | 09/19/2023 | PDL Product | October 2023 |
| NGENLA PEN 24 MG/1.2 ML | SOMATROGON-GHLA | 08/08/2023 | 09/19/2023 | PDL Product | January 2024 |
| OLPRUVA 6 GRAM DOSE ENVELOPE | SODIUM PHENYLBUTYRATE | 08/08/2023 | 09/19/2023 | PDL Product | October 2023 |
| OLPRUVA 2 GRAM DOSE ENVELOPE | SODIUM PHENYLBUTYRATE | 08/08/2023 | 09/19/2023 | PDL Product | October 2023 |
| NGENLA PEN 60 MG/1.2 ML | SOMATROGON-GHLA | 08/08/2023 | 09/19/2023 | PDL Product | January 2024 |
| XENPOZYME 4 MG VIAL | OLIPUDASE ALFA-RPCP | 08/01/2023 | 09/19/2023 | PDL Product | October 2023 |
| ROCTAVIAN 16 X 10E13 VG/8 ML | VALOCTOCOGENE ROXAPARVOVCRVOX | 07/25/2023 | 09/05/2023 | Clinical Edit | January 2024 |
| METFORMIN HCL 625 MG TABLET | METFORMIN HCL | 07/25/2023 | 09/05/2023 | PDL Product | October 2023 |
| BRIXADI MONTH 16MG/0.32ML SYR | BUPRENORPHINE | 07/19/2023 | 08/29/2023 | PDL Product | January 2024 |
| BRIXADI MONTH 64 MG/0.18ML SYR | BUPRENORPHINE | 07/19/2023 | 08/29/2023 | PDL Product | January 2024 |
| BRIXADI MONTH 8 MG/0.16ML SYR | BUPRENORPHINE | 07/19/2023 | 08/29/2023 | PDL Product | January 2024 |
| BRIXADI MONTH 24MG/0.48ML SYR | BUPRENORPHINE | 07/19/2023 | 08/29/2023 | PDL Product | January 2024 |