December 17, 2019

Texas Medicaid will publish the semi-annual update of the Medicaid preferred drug list on Jan. 27, effective Jan. 30. The update is based on changes presented and recommended at the July and Oct. 2019 Texas Drug Utilization Review Board meetings. Drug list decisions from both meetings are available. The tables below summarizes noteworthy changes for the Jan. update.

  • New preferred drug classes:
    • None

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 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, and will be updated by Jan. 30 to reflect the recent changes.

Notable changes from the July 2019 PDL recommendations:

PDL Class Drug Current Status Recommended Status
Antiparkinson’s Agents Inbrija (inhalation) No status Non-preferred
Cephalosporins and Related Antibiotics Ceprozil tablet (oral) Non-preferred Preferred
Colony Stimulating Factors Nivestym vial (injection)  No status Non-preferred
Cytokine and CAM Antagonist Skyrizi (subcutaneous) No status Non-preferred
Cytokine and CAM Antagonist Tremfya Autoinjector (subcutaneous) No status Non-preferred
GI Motility, Chronic Motegrity (oral) No status Non-preferred
Ophthalmic Antibiotics Ofloxacin (ophthalmic) Non-preferred Preferred
Ophthalmic, Glaucoma Agents Rocklatan (ophthalmic) No status Preferred
Progestational Agents Hydroxyprogesterone Caproate (intramuscular) No status Non-preferred
Ulcerative Colitis Agents Canasa (rectal) Preferred Non-preferred
Ulcerative Colitis Agents Lialda (oral) Preferred Non-preferred
Ulcerative Colitis Agents Mesalamine (Canasa) (rectal) Non-preferred Preferred

Notable changes from the Oct. 2019 PDL recommendations:

PDL Class Drug Current Status Recommended Status
Antiparasitics, Topical Sklice (topical) Preferred Non-preferred
Hypoglycemics, Insulin and related agents Humulin 500, 70/30, Pen (OTC) Non-preferred Preferred
Hypoglycemics, Insulin and related agents Humalog Pen, Mix Pen, Junior KwikPen, Cartridge Non-preferred Preferred
Hypoglycemics, Insulin and related agents Novolin Vial Non-preferred Preferred
Opiate Dependence Treatments Buprenorphine/Naloxone (tablets and film), Lucemyra Non-preferred All agents in this class are preferred
Antipsychotics Saphris (sublingual) Preferred Non-preferred
Tags: 
DUR Board
PDL