May 14, 2018

The Texas Drug Utilization Review Board held their quarterly meeting on Apr. 27, 2018, to make recommendations about clinical prior authorizations and drugs to be included on the Texas Medicaid Preferred Drug List (PDL). Available online are:

  • A recording of this meeting’s webcast
  • A report of this quarter’s clinical prior authorization and PDL recommendations
  • Approved minutes from the Jan. 27, 2018, meeting
  • The PDL drug class review schedule for July

Clinical Prior Authorization Updates

Clinical prior authorizations may implement for traditional Medicaid or managed care organizations (MCO) at any time. Providers and stakeholders will be notified once an implementation date has been set for traditional Medicaid.  Please refer to the MCO Resources for a link to each MCO's list of active clinical prior authorizations.

Presented:

Approved with recommendations:

Denied as presented:

Preferred Drug List Updates

Preferred drugs are medications recommended by the board for their efficaciousness, clinical significance, safety, and cost effectiveness. PDL recommendations are pending unitl final decisions are released by the HHSC executive commissioner. HHSC-approved decisions from the January and April 2018 board meetings will be incorporated into the next PDL, published in July 2018. MCOs will have the same non-preferred prior authorization criteria requirements from following the Texas formulary and PDL.

PDL recommendations include:

  • Tabling the Hypoglycemics, SGLT2 PDL class
  • Bronchodilators PDL class:
    • Proventil HFA recommended non-preferred
  • Cough and Cold, Non-Narcotic class:
    • Benzonatate capsule (oral) recommended non preferred
  • Glucocorticoids, Inhaled PDL class:
    • Pulmicort 0.25, 0.5, 1mg respules (inhalation) recommended preferred
    • QVAR and QVAR Redihaler recommended non-preferred
    • Flovent Diskus recommended non-preferred
  • Immunomodulators, Atopic Dermatitis class:
    • Eucrisa recommended preferred

About the Texas DUR Board

Board members meet quarterly in Austin to make recommendations about outpatient prescription drugs in the Medicaid program. The schedule of upcoming meetings, instructions on how to submit written materials to the board, and directions about publicly testifying before the board are available.