July 6, 2020
VDP routinely updates existing clinical prior authorization criteria to reflect recent FDA-approved indications or safety information from the product package insert, and will revise the Austedo (deutetrabenazine) criteria within the Vesicular Monoamine Transporter 2 (VMAT2) Inhibitors clinical prior authorization on Sept. 21, 2020:
- Austedo is indicated for the treatment of tardive dyskinesia and Huntington-induced chorea. Current criteria require prescribing by, or its use overseen by, a neurologist or psychiatrist
Revised criteria will remove the specialist requirement for only the treatment of tardive dyskinesia
- There will not be a change for the treatment of Huntington-induced chorea due to an increased risk of suicidality or suicidal ideation associated with Huntington disease
Refer to page 4 of the criteria guide (PDF) for more information.
This prior authorization is optional for Medicaid managed care. The Pharmacy Clinical Prior Authorization Assistance Chart (PDF) shows the prior authorization that each MCO uses and how they relate to the authorizations used for traditional Medicaid claims processing. This chart is updated quarterly and will be revised again in November. Providers can also refer to the VDP MCO Resources for links to each MCO's clinical prior authorizations.
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