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 |
|---|---|---|---|---|---|
| CIMERLI 0.5 MG/0.05 ML VIAL | RANIBIZUMAB-EQRN | 09/26/2022 | 11/10/2022 | PDL Product | December 2022 / January 2022 |
| TADLIQ 20 MG/5 ML SUSPENSION | TADALAFIL | 09/26/2022 | 11/17/2022 | PDL Product | December 2022 / January 2022 |
| SOTYKTU 6 MG TABLET | DEUCRAVACITINIB | 09/19/2022 | 11/01/2022 | Clinical Edit | December 2022 / January 2022 |
| ORKAMBI 75-94 MG GRANULE PKT | LUMACAFTOR/IVACAFTOR | 09/19/2022 | 11/10/2022 | Clinical Edit | December 2022 / January 2022 |
| SPEVIGO 450 MG/7.5 ML VIAL | SPESOLIMAB-SBZO | 09/12/2022 | 10/25/2022 | Clinical Edit | December 2022 / January 2022 |
| XENPOZYME 20 MG VIAL | OLIPUDASE ALFA-RPCP | 09/12/2022 | 10/25/2022 | Fiscal Edit | December 2022 / January 2022 |
| ZONISADE 100 MG/5 ML ORAL SUSP | ZONISAMIDE | 09/12/2022 | 11/01/2022 | PDL Product | December 2022 / January 2022 |
| DORYX MPC DR 60 MG TABLET | DOXYCYCLINE HYCLATE | 09/05/2022 | 10/18/2022 | Clinical Edit | December 2022 / January 2022 |
| PHEBURANE PELLET | SODIUM PHENYLBUTYRATE | 09/05/2022 | 10/25/2022 | PDL Product | December 2022 / January 2022 |
| ZTALMY 50MG/ML | GANAXOLONE | 08/29/2022 | 10/18/2022 | PDL Edit | December 2022 / January 2022 |
| CAMCEVI 42 MG SYRINGE | LEUPROLIDE MESYLATE | 08/29/2022 | 10/18/2022 | PDL Edit | December 2022 / January 2022 |
| RYALTRIS 665-25MCG SPRAY | OLOPATADINE HCL/MOMETSONE | 08/29/2022 | 10/18/2022 | Fiscal Edit | December 2022 / January 2022 |
| HYFTOR 0.2% GEL | SIROLIMUS | 08/29/2022 | 10/18/2022 | Clinical Edit | December 2022 / January 2022 |
| ZORYVE 2% CREAM | ROFLUMILAST | 08/22/2022 | 10/06/2022 | PDL Product | December 2022 / January 2022 |
| XACIATO 2% VAGINAL GEL | CLINDAMYCIN PHOSPHATE | 08/22/2022 | 10/06/2022 | Fiscal Edit | December 2022 / January 2022 |