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|
|Oseltamivir (capsules and suspension)||Non-preferred||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.