
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 |
---|---|---|---|---|---|
PIRFENIDONE 534 MG TABLET | PIRFENIDONE | 08/22/2022 | 10/11/2022 | Open Access | December 2022 / January 2022 |
XIPERE 40 MG/ML VIAL | TRIAMCINOLONE ACETONIDE | 08/22/2022 | 10/18/2022 | PDL Edit | December 2022 / January 2022 |
VIVJOA 150 MG CAPSULE | OTESECONAZOLE | 08/22/2022 | 10/06/2022 | PDL Product | December 2022 / January 2022 |
AEMCOLO DR 194 MG TABLET | RIFAMYCIN | 08/15/2022 | 10/11/2022 | Fiscal Edit | December 2022 / January 2022 |
PEGASYS 180 MCG/0.5 ML VIAL | PEGINTERFERON ALFA-2A | 08/08/2022 | 09/20/2022 | Fiscal Edit | December 2022 / January 2022 |
PEGASYS 180 MCG/0.5 ML SYRINGE | PEGINTERFERON ALFA-2A | 08/08/2022 | 09/20/2022 | Clinical Edit | December 2022 / January 2022 |
QUETIAPINE 150 MG TABLET | QUETIAPINE | 08/08/2022 | 09/20/2022 | PDL Product | December 2022 / January 2022 |
CAPLYTA 10.5 MG CAPSULE | LUMATEPERONE TOSYLATE | 07/31/2022 | 09/20/2022 | Fiscal Edit | December 2022 / January 2022 |
TASCENSO ODT 0.25 MG TABLET | FINGOLIMOD LAURYL SULFATE | 07/31/2022 | 09/13/2022 | Step Therapy Edit | December 2022 / January 2022 |
INJECTAFER 100 MG/2 ML VIAL | FERRIC CARBOXYMALTOSE | 07/31/2022 | 09/13/2022 | Fiscal Edit | December 2022 / January 2022 |
IGALMI 180 MCG SL FILM | DEXMEDETOMIDINE HCL | 07/31/2022 | 09/13/2022 | Fiscal Edit | December 2022 / January 2022 |
IGALMI 120 MCG SL FILM | DEXMEDETOMIDINE HCL | 07/31/2022 | 09/13/2022 | Clinical Edit | December 2022 / January 2022 |
CAPLYTA 21 MG CAPSULE | LUMATEPERONE TOSYLATE | 07/31/2022 | 09/13/2022 | Clinical Edit | December 2022 / January 2022 |
SUSVIMO 10 MG/0.1 ML KIT | RANIBIZUMAB/INIT FILL NEEDLE | 07/24/2022 | 09/13/2022 | PDL Product | December 2022 / January 2022 |
VENLAFAXINE BES ER 112.5 MG TB | VENLAFAXINE BESYLATE | 07/24/2022 | 09/06/2022 | Open Access | December 2022 / January 2022 |