July 1, 2019

Texas Medicaid will publish the semi-annual update of the Medicaid preferred drug list on July 25. The update is based on changes presented and recommended at the January 2019 and April 2019 Texas Drug Utilization Review Board meetings. Drug list decisions from both the January and April meetings are available. The tables below summarizes noteworthy changes for the July update.

  • New preferred drug classes:
    • Thrombopoiesis Stimulating Proteins

Drugs on the Texas Medicaid formulary are designated as preferred, non-preferred, or have neither designation. The preferred drug list includes only drugs identified as either preferred or non-preferred:

  • Drugs not on the preferred list, or drugs identified on the list as "preferred", are available to people without prior authorization.
  • Drugs on the preferred list identified as "non-preferred" will require prior authorization.
  • Some preferred and non-preferred drugs may require clinical prior authorization.
  • The Preferred Drug List Criteria Guide (PDF) outlines the criteria used to evaluate the non-preferred prior authorization requests. It will be updated by July 25 to reflect the recent changes.

Decisions from January DUR meeting

Drug Name Current Status Status as of July 25
Nexium Preferred Non-Preferred
Focalin XR Preferred Non-Preferred
Dexmethylphenidate XR Non-Preferred Preferred

Decisions from April DUR meeting

Drug Name Current Status Status as of July 25
Hemangeol Non-Preferred Preferred
Proventil HFA Non-Preferred Preferred
Cosentyx Non-Preferred Preferred