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 |
|---|---|---|---|---|---|
| ELEVIDYS 10.5-11.4 KG(10MLX11) | DELANDISTROGENE MOXEPARVCROKL | 07/05/2023 | 08/15/2023 | Clinical Edit | January 2024 |
| ELEVIDYS 48.5 -49.4 KG(10MLX49) | DELANDISTROGENE MOXEPARVC - ROKL | 07/05/2023 | 08/15/2023 | Clinical Edit | January 2024 |
| VYVGART HYTRULO 1,008MG-11,200 | EFGARTIGIMOD-HYALURONIDASQVFC | 06/27/2023 | 08/08/2023 | Clinical Edit | October 2023 |
| MIEBO 100% EYE DROP | PERFLUOROHEXYLOCTANE/PF | 06/27/2023 | 08/08/2023 | PDL Product | October 2023 |
| DERMACINRX DEXATRAN CAPSULE | MV-MINS NO.73/IRON FUM/FOLIC | 06/27/2023 | 08/08/2023 | Fiscal Edit | October 2023 |
| YUSIMRY(CF) 40 MG/0.8 ML PEN | ADALIMUMAB-AQVH | 06/27/2023 | 08/08/2023 | PDL Product | October 2023 |
| ZEPOSIA STARTER KIT (28-DAY) | OZANIMOD HYDROCHLORIDE | 06/13/2023 | 07/25/2023 | PDL Product | October 2023 |
| INPEFA 200 MG TABLET | SOTAGLIFLOZIN | 06/13/2023 | 07/25/2023 | PDL Product | October 2023 |
| NATAL PNV TABLET | PNV NO.164/IRON/FOLATE NO.6 | 06/13/2023 | 07/25/2023 | Fiscal Edit | October 2023 |
| ZAVZPRET 10 MG NASAL SPRAY | ZAVEGEPANT HCL | 06/06/2023 | 07/19/2023 | PDL Product | October 2023 |
| KALYDECO 5.8 MG GRANULES PKT | IVACAFTOR | 05/30/2023 | 07/11/2023 | Clinical Edit | October 2023 |
| OMISIRGE INFUSION KIT | OMIDUBICEL-ONLV | 05/30/2023 | 07/11/2023 | Fiscal Edit | October 2023 |
| NASONEX 24HR ALLERGY 50MCG SPR | MOMETASONE FUROATE | 05/23/2023 | 10/01/2023 | PDL Product | October 2023 |
| CUVRIOR 300 MG TABLET | Trientine | 05/23/2023 | 07/05/2023 | Fiscal Edit | October 2023 |
| VEOZAH 45 MG TABLET | FEZOLINETANT | 05/23/2023 | 07/05/2023 | Fiscal Edit | October 2023 |