C-1. Introduction

The Texas Drug Utilization Review (DUR) Board evaluates criteria used in retrospective and prospective drug utilization reviews each quarter for Medicaid. HHSC bases the criteria evaluations on drug use information available on the compendia and peer-reviewed medical literature. Criteria and standards are periodically revised to ensure they reflect the current compendia and prescribing recommendations.

HHSC may revise the criteria for individual medications or drug classes determined by the DUR Board and VDP staff based on safety issues or appropriate use. All criteria contain the following categories:

  • Dosage/Maximum Dosage
  • Duration of Therapy
  • Duplicative Therapy
  • Drug-Drug Interactions (significant)

Staff develops new retrospective criteria when the DUR Board deems it necessary, based on therapeutic and clinical materials presented at the DUR board. The information is for the convenience of the public, and HHSC is not responsible for any errors in transmission or any errors or omissions in the content. Staff with the Drug Information Service, UT Health San Antonio, and the College of Pharmacy at the University of Texas at Austin review and update the criteria on behalf of HHSC.