June 12, 2020

VDP will implement the clinical prior authorization criteria for Oxbryta (voxelotor) for traditional Medicaid on Sept. 8. The Texas Drug Utilization Review Board approved Oxbryta as part of the Sickle Cell Disease Agents criteria (PDF) at its Jan. 2020 meeting. This prior authorization is optional for Medicaid managed care. The Pharmacy Clinical Prior Authorization Assistance Chart (PDF) shows the prior authorization each MCO uses and how those authorizations relate to traditional Medicaid claim processing. This chart is updated quarterly and available on the VDP website.

Contact vdp-formulary@hhsc.state.tx.us for more information.

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Clinical PA