December 17, 2020
Texas Medicaid will publish the semi-annual update of the Medicaid preferred drug list on Jan. 28. The update is based on changes presented and recommended at the July and Oct. 2020 Texas Drug Utilization Review Board meetings. Drug list decisions from those meetings are available. The tables below summarize noteworthy changes for the Jan. update.
New preferred drug classes:
- July 2020
- Rosacea Agents, topical
- October 2020 (note: all drugs in the following PDL classes will have preferred status)
- Anticonvulsants
- Hemophilia Treatments
- HIV/AIDS
- Multiple Sclerosis Agents
- Oncology, oral – Breast
- Oncology, oral – Hematologic
- Oncology, oral – Lung
- Oncology, oral – Other
- Oncology, oral – Prostate
- Oncology, oral - Renal Cell
- Oncology, oral – skin
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. It will be updated by Jan. 25 to reflect the recent changes.
Decisions from July
| Preferred Drug Class | Drug Name | Current Status | Status as of January 28 |
| Alzeimer’s Agents | Exelon (Transderm.) | Non-Preferred | Preferred |
| Alzeimer’s Agents | Rivastigmine (Ag) (Transderm.) | Preferred | Non-Preferred |
| Alzeimer’s Agents | Rivastigmine (Transderm.) | Preferred | Non-Preferred |
| Antimigraine Agents | Ajovy Autoinjector (Subcutaneous) | No Status | Non-Preferred |
| Antimigraine Agents | Ubrelvy (Oral) | Non-Preferred | Preferred |
| Cephalosporins and Related Antibiotics | Amoxicillin/Clav Xr (Oral) | Preferred | Non-Preferred |
| Non-Steroidal Anti-Inflammatory Drugs | Diclofenac Gel (Topical) | Non-Preferred | Preferred |
| Non-Steroidal Anti-Inflammatory Drugs | Diclofenac Potassium (Oral) | Non-Preferred | Preferred |
| Non-Steroidal Anti-Inflammatory Drugs | Naproxen Ec (Oral) | Non-Preferred | Preferred |
| Otic Antibiotics | Ciprofloxacin (Otic) | Preferred | Non-Preferred |
| Otic Antibiotics | Ofloxacin (Otic) | Non-Preferred | Preferred |
| Anti-Allergens, Oral | Palforzia Maintenance Sachet (Oral) | No Status | Non-Preferred |
| Anti-Allergens, Oral | Palforzia Titration Capsule (Oral) | No Status | Non-Preferred |
| Antipsychotics | Caplyta (Oral) | No Status | Non-Preferred |
| Hypoglycemics, Incretin Mimetics/Enhancers | Trijardy Xr (Oral) | No Status | Preferred |
| Hypoglycemics, Metformins | Riomet Er Suspension (Oral) | No Status | Non-Preferred |
| Immune Globulins | Hizentra Syringe (Subcutaneous) | No Status | Non-Preferred |
| Lipotropics, Other | Nexletol (Oral) | No Status | Non-Preferred |
Decisions from Oct.
| Preferred Drug Class | Drug Name | Current Status | Status as of January 28 |
| Antiparasitics, topical | Vanalice Gel, OTC | Non-Preferred | Preferred |
| Antipsychotics | Caplyta (oral) | No Status | Non-Preferred |
| Antipsychotics | Fluphenazine Decanoate (injection) | No Status | Non-Preferred |
| Antipsychotics | Haldol Decanoate (intrmusc) | No Status | Non-Preferred |
| Antipsychotics | Haloperidol Decanoate (injection) | No Status | Preferred |
| Antipsychotics | Geodon (intramusc) | No Status | Non-Preferred |
| Antipsychotics | Haloperidol Lactate (injection) | No Status | Non-Preferred |
| Antipsychotics | Olanzapine (intramusc) | No Status | Non-Preferred |
| Antipsychotics | Zypreza (intramusc) | No Status | Non-Preferred |
| Colonly Stimluting Factors | Fulphila (subcutaneous) | Preferred | Non-Preferred |
| Colony Stimlulating Factors | Granix Syringe (injection) | Preferred | Non-Preferred |
| Gastrointestinal Motility, chronic | Amitiza (oral) | Non-Preferred | Preferred |
| Hepatitis C Agents | Harvoni Pellect Pack (oral) | No Status | Non-Preferred |
| Hepatitis C Agents | Sovaldi Pellet Pack (oral) | No Status | Non-Preferred |
| Macrolides-Ketolides | Eryped 200 Suspension (oral) | Non-Preferred | Preferred |
| Macrolides-Ketolides | Eryped 400 Suspension (oral) | Non-Preferred | Preferred |
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