December 15, 2017

Texas Medicaid will implement the semi-annual update of the Medicaid preferred drug list (PDL) on Thursday, Jan. 25, 2018. The update is based on changes presented at the Drug Utilization Review (DUR) Board meetings in Jul. and Nov. 2017.

New therapeutic classes include:

  • Progestational Agents
  • Pediatric vitamin preparations
  • Antihistamines, first generation
Noteworthy Changes in Jan. 2018 PDL (Approved)
Drug Board Reviewed Current Status Jan. PDL Status
Exelon Jul. 2017 Preferred Non-preferred
Memantine tablet Jul. 2017 Preferred Non-preferred
Rivastigmine Jul. 2017 Non-preferred Preferred
Suprax Jul. 2017 Preferred Non-preferred
Emflaza suspension and tablet Jul. 2017 Not previously reviewed Non-preferred
Farxiga (oral) Jul. 2017 Non-preferred Preferred
Invokamet XR (oral) Jul. 2017 Not previously reviewed Non-preferred
Invokamet (oral) Jul. 2017 Preferred Non-preferred
Invokana (oral) Jul. 2017 Preferred Non-preferred
Jardiance (oral) Jul. 2017 Non-preferred Preferred
Synjardy (oral) Jul. 2017 Non-preferred Preferred
Synjardy XR (oral) Jul. 2017 Not previously reviewed Non-preferred
Makena MDV Jul. 2017 Not previously reviewed Preferred
Makena SDV Jul. 2017 Not previously reviewed Preferred

Noteworthy Changes in Jan. 2018 PDL (Pending HHS EC Approval)
Drug Board Reviewed Current Status Jan. PDL Status
Tamilflu (Approved with immunosuppressive diagnosis) Nov. 2017 † Preferred Non-preferred
Diclegis Nov. 2017 † Preferred Non-preferred
Abilify Nov. 2017 † Preferred Non-preferred
Aripiprazole Nov. 2017 † N Preferred
Strattera Nov. 2017 † Preferred Non-preferred
Atomoxetine Nov. 2017 † N Preferred
Latuda Nov. 2017 † Preferred Non-preferred

Drugs on the Texas Medicaid formulary are designated as preferred or non-preferred or have neither designation, and the PDL contains only drugs designated as preferred or non-preferred:

  • Drugs identified on the PDL as preferred, or not listed at all, are available to individuals without prior authorization.
  • Drugs identified as non-preferred require a PDL prior authorization.

In addition, clinical prior authorizations may apply to any individual drug or an entire drug class on the formulary, including some preferred and non-preferred drugs.  The PDL Criteria Guide (PDF) explains the criteria used to evaluate the PDL prior authorization requests, and will be updated by Jan. 19.