August 16, 2017

On September 15, the Vendor Drug Program will modify the cystic fibrosis prior authorization, adding five mutations to the cystic fibrosis transmembrane conductance regulator gene that are responsive to Kalydeco (ivacaftor). New mutations of the gene include:

  • 2789+5G→A
  • 3272-26A→G
  • 3849+10kbC→T
  • 711+3A→G
  • E831X

This prior authorization is optional for Medicaid managed care. The Pharmacy Clinical Prior Authorization Assistance Chart (PDF) shows the prior authorization each MCO uses and how they relate to those used for traditional Medicaid claim processing. This chart is updated quarterly.  For questions, email