February 14, 2018

HHSC will publish an update to the Texas Medicaid Preferred Drug List (PDL) on Mar. 9 that includes changes approved at the Nov. 3, 2017, Drug Utilization Review Board meeting.  As a reminder, the PDL that was published on Feb. 1 was based only the approved decisions from the Jul. 28, 2017, meeting.

The table below summarizes some of the noteworthy changes from the Nov. meeting.

Drug Name Current status March 9, 2018  Status
Abilify Preferred Non-preferred
Aripiprazole Non-preferred Preferred
Atomoxetine Non-preferred Preferred
Diclegis Preferred Non-preferred
Latuda Preferred Preferred
Oseltamivir (capsules and suspension) Non-preferred Preferred
Strattera Preferred Non-preferred
Tamilflu (capsules and suspension) Preferred Preferred

New therapeutic classes include:

  • Pediatric vitamin preparations
  • Antihistamines, first generation

Drugs on the Texas Medicaid formulary are designated as preferred, non-preferred, or neither designation. The PDL is a list of only drugs designated as preferred or non-preferred status. Most drugs are identified as preferred or non-preferred.  Drugs identified on the PDL as preferred, or not listed at all, are available to individuals without PDL 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.  The criteria guide will be updated by Mar. 5.